{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T03:08:42Z","timestamp":1780369722695,"version":"3.54.1"},"reference-count":34,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,9,20]],"date-time":"2018-09-20T00:00:00Z","timestamp":1537401600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A valid bronchoscopic scoring tool for bronchitis would be useful for clinical and research purposes as currently there are none in children. From 100 digitally recorded flexible bronchoscopies (FB), we related the various macroscopic features to airway neutrophil % to develop a FB\u2010derived bronchitis score (BScore<jats:sub>exp<\/jats:sub>). We aimed to develop a FB\u2010derived bronchitis tool.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>FB recordings for six visualised features: secretions (amount and color) and mucosal appearance (erythema, pallor, ridging, oedema) based on pre\u2010determined criteria on a pictorial chart were assessed by two physicians independently, blinded to the clinical history. These features were used to obtain various models of BScore<jats:sub>exp<\/jats:sub> that were plotted against bronchoalveolar lavage (BAL) neutrophil % using a receiver operating characteristic (ROC) curve. Inter\u2010 and intra\u2010rater agreement (weighted\u2010kappa, <jats:italic>K<\/jats:italic>) were assessed from 30\u2009FBs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Using BAL neutrophilia of 20% to define inflammation, the highest area under ROC (aROC) of 0.71, 95%CI 0.61\u20100.82 was obtained by the giving three times weightage to secretion amount and color and adding it to erythema and oedema. Inter\u2010rater <jats:italic>K<\/jats:italic> values for secretion amount (<jats:italic>K<\/jats:italic>\u2009=\u20090.87, 95%CI 0.73\u20101.0) and color (<jats:italic>K<\/jats:italic>\u2009=\u20090.86, 95%CI 0.69\u20101.0) were excellent. Respective intra\u2010rater <jats:italic>K<\/jats:italic> were 0.95 (0.87\u20101.0) and 0.68 (0.47\u20100.89). Other inter\u2010rater <jats:italic>K<\/jats:italic> ranged from 0.4 (erythema) to 0.64 (pallor).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A repeatable FB\u2010defined bronchitis scoring tool can be derived. However, a prospective study needs to be performed with larger numbers to further evaluate and validate these results.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.24163","type":"journal-article","created":{"date-parts":[[2018,9,21]],"date-time":"2018-09-21T21:12:10Z","timestamp":1537564330000},"page":"1510-1516","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Towards developing a valid scoring tool for bronchitis during flexible bronchoscopy"],"prefix":"10.1002","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8171-3261","authenticated-orcid":false,"given":"Rahul J.","family":"Thomas","sequence":"first","affiliation":[{"name":"Department of Respiratory and Sleep Medicine Lady Cilento Children's Hospital Children Centre for Health Research Queensland University of Technology Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kah P.","family":"Eg","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Sleep Medicine Lady Cilento Children's Hospital Children Centre for Health Research Queensland University of Technology Brisbane Queensland Australia"},{"name":"Department of Paediatrics University of Malaya Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian B.","family":"Masters","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Sleep Medicine Lady Cilento Children's Hospital Children Centre for Health Research Queensland University of Technology Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"McElrea","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Sleep Medicine Lady Cilento Children's Hospital Children Centre for Health Research Queensland University of Technology Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne B.","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Sleep Medicine Lady Cilento Children's Hospital Children Centre for Health Research Queensland University of Technology Brisbane Queensland Australia"},{"name":"Child Health Division Menzies School of Health Research Charles Darwin University Darwin Northern Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,9,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.23957"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.103.5.1482"},{"key":"e_1_2_8_4_1","first-page":"1039","article-title":"Characteristics of children with endoscopically proved chronic bronchitis","volume":"139","author":"Smith TF","year":"1985","journal-title":"Am J Dis Child"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00035111"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.56.5.366"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.20478"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.22792"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.23931"},{"key":"e_1_2_8_10_1","first-page":"217","article-title":"ERS task force bronchial alveolar lavage in children","volume":"2000","author":"de Blic JMF","journal-title":"Eur Respir J"},{"key":"e_1_2_8_11_1","unstructured":"EngJ.Web based calculator for ROC curves Baltimore: John Hopkins University; [updated2014March 19]. 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