title: Disability after encephalitis: development and validation of a new outcome score.
abstract: OBJECTIVE
  To develop a simple tool for assessing the severity of disability resulting from Japanese encephalitis and whether, as a result, a child is likely to be dependent.
  
  
  METHODS
  A new outcome score based on a 15-item questionnaire was developed after a literature review, examination of current assessment tools, discussion with experts and a pilot study. The score was used to evaluate 100 children in Malaysia (56 Japanese encephalitis patients, 2 patients with encephalitis of unknown etiology and 42 controls) and 95 in India (36 Japanese encephalitis patients, 41 patients with encephalitis of unknown etiology and 18 controls). Inter- and intra-observer variability in the outcome score was determined and the score was compared with full clinical assessment.
  
  
  RESULTS
  There was good inter-observer agreement on using the new score to identify likely dependency (Kappa = 0.942 for Malaysian children; Kappa = 0.786 for Indian children) and good intra-observer agreement (Kappa = 1.000 and 0.902, respectively). In addition, agreement between the new score and clinical assessment was also good (Kappa = 0.906 and 0.762, respectively). The sensitivity and specificity of the new score for identifying children likely to be dependent were 100% and 98.4% in Malaysia and 100% and 93.8% in India. Positive and negative predictive values were 84.2% and 100% in Malaysia and 65.6% and 100% in India.
  
  
  CONCLUSIONS
  The new tool for assessing disability in children after Japanese encephalitis was simple to use and scores correlated well with clinical assessment.
authors.affiliation: University of Liverpool, England. pennylewthwaite@doctors.org.uk
authors.forename: Penny
authors.initials: P
authors.lastname: Lewthwaite
authors.forename: Ashia
authors.initials: A
authors.lastname: Begum
authors.forename: Mong How
authors.initials: MH
authors.lastname: Ooi
authors.forename: Brian
authors.initials: B
authors.lastname: Faragher
authors.forename: Boon Foo
authors.initials: BF
authors.lastname: Lai
authors.forename: Indunil
authors.initials: I
authors.lastname: Sandaradura
authors.forename: Anand
authors.initials: A
authors.lastname: Mohan
authors.forename: Gaurav
authors.initials: G
authors.lastname: Mandhan
authors.forename: Pratibha
authors.initials: P
authors.lastname: Meharwade
authors.forename: S
authors.initials: S
authors.lastname: Subhashini
authors.forename: Gulia
authors.initials: G
authors.lastname: Abhishek
authors.forename: Asma
authors.initials: A
authors.lastname: Begum
authors.forename: Srihari
authors.initials: S
authors.lastname: Penkulinti
authors.forename: M Veera
authors.initials: MV
authors.lastname: Shankar
authors.forename: R
authors.initials: R
authors.lastname: Ravikumar
authors.forename: Carolyn
authors.initials: C
authors.lastname: Young
authors.forename: Mary Jane
authors.initials: MJ
authors.lastname: Cardosa
authors.forename: V
authors.initials: V
authors.lastname: Ravi
authors.forename: See Chang
authors.initials: SC
authors.lastname: Wong
authors.forename: Rachel
authors.initials: R
authors.lastname: Kneen
authors.forename: Tom
authors.initials: T
authors.lastname: Solomon
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004185:Disability Evaluation; D006233:Persons with Disabilities; D004660:Encephalitis / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007194:India; D008296:Malaysia; D008297:Male; D010865:Pilot Projects; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires / Q000592:standards*