PERSPECTIVES
Diagnosis
Can we predict vesicoureteric reflux?
Correspondence to:
Correspondence to:
Dr J H Baumer
Derriford Hospital, Plymouth, Devon PL6 8DH, UK; harry.baumer@phnt.swest.nhs.uk
Commentary on the paper by Leroy et al (see page241)
Keywords: vesicoureteric; cystourethrogram; prediction; reflux
| The first 150 words of the full text of this article appear below. |
Many children are investigated for vesicoureteric reflux (VUR) following a urinary tract infection (UTI), but the imaging technique of a voiding cystourethrogram (VCUG) is unpleasant for the child and not without risk. A clinical scoring system capable of confidently predicting VUR would therefore be an attractive alternative approach.
The original study by Oostenbrink and colleagues1 seemed to suggest that a score derived from the combination of clinical factors (age, sex, and positive family history), ultrasound findings and C reactive protein (CRP) result could predict the presence of VUR with high sensitivity, albeit with rather low specificity. A diagnostic test with 100% sensitivity can be useful in ruling out a condition when it is negative, even when it has low specificity (that is, cannot be relied upon when positive). This has been referred to as a "SnNout" (when a test has a high Sensitivity, a Negative
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Relevant Article
- Prediction of vesicoureteral reflux after a first febrile urinary tract infection in children: validation of a clinical decision rule
- S Leroy, E Marc, C Adamsbaum, D Gendrel, G Bréart, and M Chalumeau
Arch. Dis. Child. 2006 91: 241-244.[Abstract] [Full Text] [PDF]
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