Bronchiolitis Score of Sant Joan de Déu: BROSJOD Score, validation and usefulness.
To validate the bronchiolitis score of Sant Joan de Déu (BROSJOD) and to examine the previously defined scoring cutoff.



Prospective, observational study. BROSJOD scoring was done by two independent physicians (at admission, 24 and 48 hr). Internal consistency of the score was assessed using Cronbach's α. To determine inter-rater reliability, the concordance correlation coefficient estimated as an intraclass correlation coefficient (CCC) and limits of agreement estimated as the 90% total deviation index (TDI) were estimated. An expert opinion was used to classify patients according to clinical severity. A validity analysis was conducted comparing the 3-level classification score to that expert opinion. Volume under the surface (VUS), predictive values, and probability of correct classification (PCC) were measured to assess discriminant validity.



About 112 patients were recruited, 62 of them (55.4%) males. Median age: 52.5 days (IQR: 32.75-115.25). The admission Cronbach's α was 0.77 (CI95%: 0.71; 0.82) and at 24 hr it was 0.65 (CI95%: 0.48; 0.7). The inter-rater reliability analysis was: CCC at admission 0.96 (95%CI 0.94-0.97), at 24 h 0.77 (95%CI 0.65-0.86), and at 48 hr 0.94 (95%CI 0.94-0.97); TDI 90%: 1.6, 2.9, and 1.57, respectively. The discriminant validity at admission: VUS of 0.8 (95%CI 0.70-0.90), at 24 h 0.92 (95%CI 0.85-0.99), and at 48 hr 0.93 (95%CI 0.87-0.99). The predictive values and PCC values were within 38-100% depending on the level of clinical severity.



There is a high inter-rater reliability, showing the BROSJOD score to be reliable and valid, even when different observers apply it. Pediatr Pulmonol. 2017;52:533-539. © 2016 Wiley Periodicals, Inc.
Pediatric Critical Care Unit, Hospital Sant Joan de Deu, Pg. Sant Joan de Deu n°2, Esplugues de Llobregat 08950, Barcelona, Spain.
Mònica
M
Balaguer
Pediatric Critical Care Unit, Hospital Sant Joan de Deu, Pg. Sant Joan de Deu n°2, Esplugues de Llobregat 08950, Barcelona, Spain.
Carme
C
Alejandre
Pediatric Critical Care Unit, Hospital Sant Joan de Deu, Pg. Sant Joan de Deu n°2, Esplugues de Llobregat 08950, Barcelona, Spain.
David
D
Vila
Pediatric Critical Care Unit, Hospital Sant Joan de Deu, Pg. Sant Joan de Deu n°2, Esplugues de Llobregat 08950, Barcelona, Spain.
Elisabeth
E
Esteban
Biostatistics, Public Health Department, University of Barcelona, Barcelona, Spain.
Josep L
JL
Carrasco
Pediatric Critical Care Unit, Hospital Sant Joan de Deu, Pg. Sant Joan de Deu n°2, Esplugues de Llobregat 08950, Barcelona, Spain.
Francisco José
FJ
Cambra
Pediatric Critical Care Unit, Hospital Sant Joan de Deu, Pg. Sant Joan de Deu n°2, Esplugues de Llobregat 08950, Barcelona, Spain.|Paediatric Intensive Care Unit, CIBERESP, Agrupación Hospitalaria Clínic-Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.
Iolanda
I
Jordan
D001988:Bronchiolitis / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015588:Observer Variation; D011446:Prospective Studies; D015203:Reproducibility of Results; D012720:Severity of Illness Index
bronchiolitis; score