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ELECTRONIC ARTICLE: Robert C. Holman, Aaron T. Curns, James E. Cheek, Joseph S. Bresee, Rosalyn J. Singleton, Karen Carver, and Larry J. Anderson Respiratory Syncytial Virus Hospitalizations Among American Indian and Alaska Native Infants and the General United States Infant Population Pediatrics 2004; 114: e437-e444 [Abstract] [Full text] [PDF]

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Considerations about diagnostic criteria for RSV infection

Rejane Oravec, Vanessa Cunha, Janice Lukrafka, Sandra C. Fuchs   (8 December 2004)

Considerations about diagnostic criteria for RSV infection 8 December 2004
Rejane Oravec, Clinical Pathologist , Vanessa Cunha, Janice Lukrafka, Sandra C. Fuchs Send letter to journal: Re: Considerations about diagnostic criteria for RSV infection oravec{at}terra.com.br Rejane Oravec, et al.	Please, find attached the “letter to the editor” in relation to the paper “Respiratory syncytial Virus Hospitalizations Among American Indian and Alaska Native Infants and the General United States Infant population”, which I am submitting to be considered for publication in the Pediatrics. All authors have seen and approved of the study submitted. We do not have financial or other relationships that might lead to a conflict of interest. Holman et al.1 described the burden of respiratory syncytial virus (RSV) among Americam Indian (AI) and Alaska native (AN) infants, through the examination of the hospital discharge records. RSV-associated hospitalizations due to bronchiolitis, pneumonia and other diseases were determined using the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM). The authors pointed out that the use of ICD-9 is a limitation of the study. They recognized that the diagnostic criteria might vary regionally, reimbursement may influence positively the registry of some diagnosis and other reasons for concern, but they did not consider them as flawing the results. The argument presented that 89% of the infants with a RSV ICD-9-CM code had a positive laboratory result and that 80% of those tested positive for RSV had a compatible IDC-9-CM code at the discharge is a circular reasoning, which did not cover the fact that only half of the children were tested for RSV. So the results may be valid for half of the children, but what about the other half? A recent review highlighted the low number of community-based longitudinal studies of acute lower respiratory infection in children which met minimum quality criteria to permit a meaningful meta-analysis of the data2. References 1. Holman RC, Curns AT, Cheek JE, Bresee JS, Singleton RJ, Carver K, Anderson IJ. Respiratory Syncytial Virus Hospitalizations Among Americam Indian and Alaska Native Infants and the General United States Infant Population. Pediatrics. 2004;114(4): e437-44. 2. Lanata CF, Rudan I, Boschi-Pinto C, Tomaskovic L, Cherian T, Weber M, Campbell H. Methodological and quality issues in epidemiological studies of acute lower respiratory infections in children in developing countries. Int J Epidemiol. 2004;33:1-11.