Table 3

Diagnostic reclassification by the updated Feverkidstool compared with the original Feverkidstool

a.Reference standard diagnosis:
Pneumonia (n=30)
Reference standard diagnosis:
No pneumonia (n=561)*
Updated Feverkidstool predicted risk for pneumonia Updated Feverkidstool predicted risk for pneumonia
LowIntermediateHighLowIntermediateHigh
Original Feverkidstool predicted risk for pneumonia‡ Low311304203
Intermediate1241004627
High0018141433
b.Reference standard diagnosis:
Other SBIs (n=66)
Reference standard diagnosis:
No other SBIs (n=525)†
Updated Feverkidstool predicted risk for other SBIs Updated Feverkidstool predicted risk for other SBIs
LowIntermediateHighLowIntermediateHigh
Original Feverkidstool predicted risk for other SBIs§ Low1009800
Intermediate1261905525
High0452405166
  • The Feverkidstool classification was compared with the majority reference standard for the prediction of pneumonia (A) and other SBIs (B). Head-to-head comparison of the original Feverkidstool and the updated Feverkidstool. Predicted risks of pneumonia (A) and other SBIs (B) were low if the predicted risk was below 2.5%, intermediate between 2.5% and 10%, and high above 10%.

  • *As the comparison in this table is between the presence or absence of pneumonia, it should be noted that ‘no pneumonia’ includes viral and other SBIs.

  • †As the comparison in this table is between the presence or absence of other SBIs, it should be noted that ‘no other SBIs’ includes viral and pneumonia.

  • ‡Among the patients with pneumonia as determined by the majority in the expert panel, six patients were correctly reclassified as being at higher risk using the updated Feverkidstool instead of the original Feverkidstool and one patient was incorrectly reclassified. For patients in whom pneumonia was absent, these numbers are respectively 128 and 50. Reclassification improvement was 17% for patients with pneumonia (6 minus 1 of 30) and 14% for patients without pneumonia (128 minus 50 of 561).

  • §Among the patients with other SBIs as determined by the majority in the expert panel, six patients were correctly reclassified using the updated Feverkidstool instead of the original Feverkidstool and five patients were incorrectly reclassified. For patients in whom other SBIs are absent, these numbers are respectively 281 and 25. Reclassification improvement was 2% for patients with other SBIs (6 minus 5 of total 66) and 49% for patients without other SBIs (281 minus 25 of 525).

  • SBI, serious bacterial infection.