Sensitivity, specificity, PPV and NPV of various modifications to the revised Mirzapur 11-sign algorithm for VSD (n=395)
| Prevalence, % (95% CI) | Sensitivity, % (95% CI) | Specificity, % (95% CI) | PPV, % (95% CI) | NPV, % (95% CI) | κ Statistic (p value) | |
|---|---|---|---|---|---|---|
| Modification of revised 11-sign algorithm | ||||||
| Modification A | 4.3 (2.5 to 6.8) | 62.5 (35.4 to 84.8) | 98.2 (96.2 to 99.3) | 58.8 (32.9 to 81.6) | 98.4 (96.6 to 99.4) | 0.59 (0.00) |
| Modification B | 4.1 (2.3 to 6.5) | 62.5 (35.4 to 84.8) | 98.4 (96.6 to 99.4) | 62.5 (35.4 to 84.8) | 98.4 (96.6 to 99.4) | 0.61 (0.00) |
| Modification C | 7.3 (5.0 to 10.4) | 81.3 (54.4 to 96.0) | 95.8 (93.2 to 97.6) | 44.8 (26.4 to 64.3) | 99.2 (97.6 to 99.8) | 0.55 (0.00) |
| Modification D | 7.3 (5.0 to 10.4) | 81.3 (54.4 to 96.0) | 95.8 (93.2 to 97.6) | 44.8 (26.4 to 64.3) | 99.2 (97.6 to 99.8) | 0.55 (0.00) |
| Modification E | 9.1 (6.5 to 12.4) | 81.3 (54.4 to 96.0) | 93.9 (91.0 to 96.1) | 36.1 (20.8 to 53.8) | 99.2 (97.6 to 99.8) | 0.47 (0.00) |
| Modification F | 7.1 (4.8 to 10.1) | 81.3 (54.4 to 96.0) | 96.0 (93.6 to 97.8) | 46.4 (27.5 to 66.1) | 99.2 (97.6 to 99.8) | 0.57 (0.00) |
| Modification G | 5.1 (3.1 to 7.7) | 68.8 (41.3 to 89.0) | 97.6 (95.5 to 98.9) | 55.0 (31.5 to 76.9) | 98.7 (96.9 to 99.6) | 0.59 (0.00) |
| Modification of YIS7 algorithm | ||||||
| Modification X | 7.3 (5.0 to 10.4) | 68.8 (41.3 to 89.0) | 95.3 (92.6 to 97.2) | 37.9 (20.7 to 57.7) | 98.6 (96.8 to 99.6) | 0.46 (0.00) |
| Modification Y | 5.3 (3.3 to 8.0) | 68.8 (41.3 to 89.0) | 97.4 (95.2 to 98.7) | 52.4 (29.8 to 74.3) | 98.7 (96.9 to 99.6) | 0.58 (0.00) |
| Modification Z | 7.3 (5.0 to 10.4) | 81.3 (54.4 to 96.0) | 95.8 (93.2 to 97.6) | 44.8 (26.4 to 64.3) | 99.2 (97.6 to 99.8) | 0.55 (0.00) |
Screening was conducted to identify need for urgent referral-level evaluation for severe neonatal diseases. Lists of signs and symptoms for algorithms are presented in online supplementary table 1.
NPV, negative predictive value; PPV, positive predictive value; VSD, very severe disease; YIS7, Young Infant Study 7-sign.
Kappa statistic between the computed VSD based on child's assessment and referral need.