{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T10:34:39Z","timestamp":1753180479861},"reference-count":63,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,9,16]],"date-time":"2021-09-16T00:00:00Z","timestamp":1631750400000},"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":["Tropical Med Int Health"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Accurately assessing dehydration severity is a critical step in reducing mortality from diarrhoea, but is complicated by cholera and undernutrition. This study seeks to assess the accuracy of two clinical diagnostic models for dehydration among patients over five years with cholera and undernutrition and compare their respective performance to the World Health Organization (WHO) algorithm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this secondary analysis of data collected from the NIRUDAK study, accuracy of the full and simplified NIRUDAK models for predicting severe and any dehydration was measured using the area under the Receiver Operator Characteristic curve (AUC) among patients over five with\/without cholera and with\/without wasting. Bootstrap with 1000 iterations was used to compare the m\u2010index for each NIRUDAK model to that of the WHO algorithm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 2,139 and 2,108 patients were included in the nutrition and cholera subgroups respectively with an overall median age of 35\u00a0years (IQR\u00a0=\u00a042) and 49.6% female. All subgroups had acceptable discrimination in diagnosing severe or any dehydration (AUC\u00a0&gt;\u00a00.60); though the full NIRUDAK model performed best among patients without cholera, with an AUC of 0.82 (95%CI:0.79, 0.85) and among patients without wasting, with an AUC of 0.79 (95%CI:0.76, 0.81). Compared with the WHO\u2019s algorithm, both the full and simplified NIRUDAK models performed significantly better in terms of their m\u2010index (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) for all comparisons, except for the simplified NIRUDAK model in the wasting group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Both the full and simplified NIRUDAK models performed less well in patients over five years with cholera and\/or wasting; however, both performed better than the WHO algorithm.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.13675","type":"journal-article","created":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T18:25:41Z","timestamp":1630520741000},"page":"1512-1525","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Assessing the performance of clinical diagnostic models for dehydration among patients with cholera and undernutrition in Bangladesh"],"prefix":"10.1111","volume":"26","author":[{"given":"Monique","family":"Gainey","sequence":"first","affiliation":[{"name":"Rhode Island Hospital Providence RI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kexin","family":"Qu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Brown University School of Public Health Providence RI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie C.","family":"Garbern","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Alpert Medical School Brown University Providence RI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meagan A.","family":"Barry","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Alpert Medical School Brown University Providence RI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John Austin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Alpert Medical School Brown University Providence RI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabiha","family":"Nasrin","sequence":"additional","affiliation":[{"name":"International Centre for Diarrhoeal Disease Research Dhaka Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmuda","family":"Monjory","sequence":"additional","affiliation":[{"name":"International Centre for Diarrhoeal Disease Research Dhaka Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric J.","family":"Nelson","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and Environmental and Global Health Emerging Pathogens Institute University of Florida Gainesville FL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rochelle","family":"Rosen","sequence":"additional","affiliation":[{"name":"Department of Behavioral and Social Sciences School of Public Health Brown University Providence RI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nur H.","family":"Alam","sequence":"additional","affiliation":[{"name":"International Centre for Diarrhoeal Disease Research Dhaka Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher H.","family":"Schmid","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Brown University School of Public Health Providence RI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam C.","family":"Levine","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Alpert Medical School Brown University Providence RI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,9,16]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30925-9"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-12-276"},{"key":"e_1_2_9_4_1","unstructured":"Institute for Health Metrics and Evaluation (IHME).GBD Compare[Internet]. 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