Category | UTICalc (≥2%) | Gorelick score (≥2 variables) | DUTY (≥5 points) points-based algorithm |
---|---|---|---|
Number of UTIs / number of children included, n | 4 / 96 | 23 / 100 | 26 / 297 |
Population | 3 months–2 years with fever and no urinary tract abnormalities | 3 months–2 years with fever | 3 months–5 years with acute illness |
Variables | Age <12 months; fever ≥39°C; non-Black ethnicity; female sex; uncircumcised male; and fever without sourcea | Aged <12 months; White ethnicity; fever ≥39°C; fever ≥2 days; fever without sourceb | Dysuria (2 points); malodorous urine (2 points); history of UTI (1 point); absence of severe cough (2 points); severity of illness (2 points when >6 on a scale of 0–10) |
Reference standard | 1 or 2 pathogens >5 × 104 CFU/ml and pyuria | 1 or 2 pathogens >5 × 104 CFU/ml | 1 pathogen >105 CFU/ml |
Sensitivity / specificity, derivation study, % (95% CI) | 95 (NR) / 35 (NR) | 95 (85 to 99) / 31 (28 to 34) | 52 (39 to 64) / 95 (94 to 95) |
Sensitivity / specificity, ERNIE4 study, % (95% CI) | 75 (19 to 99) / 16 (9 to 25) | 91 (72 to 99) / 8 (3 to 16) | 8 (1 to 25) / 99 (96 to 100) |
Urine sampling rate followingprediction rule / routine care, % (95% CI) | 72 (62 to 81) / 38 (28 to 48) | 92 (85 to 97) / 38 (29 to 48) | 1 (0.8 to 4) / 32 (26 to 37) |
Number of missed infections,prediction rule versus routine care, n | 1/4 versus 2/4 | 2/23 versus 17/23 | 24/26 versus 16/26 |
aDefined in the original study as no upper respiratory tract infection, no bronchiolitis, no pneumonia, no acute otitis media, no gastroenteritis, no meningitis, and no viral syndrome. bdefined in the original study as discharge diagnoses: ‘fever’, ‘fever without source’, or ‘viral infection’. CFU = colony-forming unit. DUTY = Diagnosis of Urinary Tract Infections in Children. NR = not reported. UTI = urinary tract infection. UTICalc = UTI Calculator.