{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T15:00:38Z","timestamp":1774969238671,"version":"3.50.1"},"reference-count":23,"publisher":"Royal College of General Practitioners","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BJGP Open"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Diagnosing childhood urinary tract infections (UTIs) is challenging. Clinical prediction rules may help to identify children that require urine sampling. However, there is a lack of research to determine the accuracy of the scores in general practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To validate clinical prediction rules (UTI Calculator [UTICalc], A Diagnosis of Urinary Tract Infection in Young Children [DUTY], and Gorelick score) for paediatric UTIs in primary care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design &amp; setting<\/jats:title><jats:p>Post-hoc analysis of a cross-sectional study in 39 general practices and two emergency departments (EDs). The study took place in Belgium from March 2019\u2013March 2020.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Physicians recruited acutely ill children aged \u226418 years and sampled urine systematically for culture. Per rule, an apparent validation was performed, and sensitivities and specificities were calculated with 95% confidence intervals (CIs) per threshold in the target group. For the DUTY coefficient-based algorithm, a logistic calibration was performed and the area under the receiver operating characteristic curve (AUC) was calculated with 95% CI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 834 children aged \u226418 years recruited, there were 297 children aged &lt;5 years. The UTICalc and Gorelick score had high-to-moderate sensitivity and low specificity: UTICalc (\u22652%) 75% and 16%, respectively; Gorelick (\u22652 variables) 91% and 8%, respectively. In contrast, the DUTY score \u22655 points had low sensitivity (8%) but high specificity (99%). Urine samples would be obtained in 72% versus 38% (UTICalc), 92% versus 38% (Gorelick) or 1% versus 32% (DUTY) of children, compared with routine care. The number of missed infections per score was 1\/4 (UTICalc), 2\/23 (Gorelick), and 24\/26 (DUTY). The UTICalc + dipstick model had high sensitivity and specificity (100% and 91%), resulting in no missed cases and 59% (95% CI = 49% to 68%) of antibiotics prescribed inappropriately.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this study, the UTICalc and Gorelick score were useful for ruling out UTI, but resulted in high urine sampling rates. The DUTY score had low sensitivity, meaning that 92% of UTIs would be missed.<\/jats:p><\/jats:sec>","DOI":"10.3399\/bjgpo.2021.0171","type":"journal-article","created":{"date-parts":[[2022,1,14]],"date-time":"2022-01-14T14:40:14Z","timestamp":1642171214000},"page":"BJGPO.2021.0171","source":"Crossref","is-referenced-by-count":4,"title":["Clinical prediction rules for childhood urinary tract infections: a cross-sectional study in ambulatory care"],"prefix":"10.3399","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3278-4626","authenticated-orcid":false,"given":"Hanne Ann","family":"Boon","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7166-7211","authenticated-orcid":false,"given":"Jan Y","family":"Verbakel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0561-6504","authenticated-orcid":false,"given":"Tine","family":"De Burghgraeve","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann Van den","family":"Bruel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1987","published-online":{"date-parts":[[2022,1,14]]},"reference":[{"key":"2023031608374505000_6.2.BJGPO.2021.0171.1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e31815e4122"},{"key":"2023031608374505000_6.2.BJGPO.2021.0171.2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2016.1181"},{"key":"2023031608374505000_6.2.BJGPO.2021.0171.3","doi-asserted-by":"publisher","DOI":"10.1370\/afm.2684"},{"issue":"10","key":"2023031608374505000_6.2.BJGPO.2021.0171.4","first-page":"940","article-title":"Revised AAP guideline on UTI in febrile infants and young children","author":"Roberts","year":"2012","journal-title":"Am Fam Physician"},{"key":"2023031608374505000_6.2.BJGPO.2021.0171.5","unstructured":"National Institute for Health and Care Excellence (2018) Urinary tract infection in under 16s: diagnosis and management. 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