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Table 3 Expert panel qualitative assessments of potential prognostic indicators

From: Predictors of treatment failure for non-severe childhood pneumonia in developing countries – systematic literature review and expert survey – the first step towards a community focused mHealth risk-assessment tool?

Prognostic indicator Overall favorability Selected performance comments Selected feasibility comments
Fever Unfavorable Low specificity for identifying children who will not fail treatment High feasibility since already implemented and measurement tools simple
Rapid breathing Minimally favorable Normal range highly variable Measurement tools inaccurate
Low sensitivity for hypoxemic children Low feasibility with respect to sequential monitoring of respiratory rates over time
Performance profile improves with sequential monitoring of respiratory rates over time  
Lower chest wall indrawing Favorable Low specificity for identifying children who will not fail treatment Subjective sign with variable inter-provider agreement levels
Abnormal oxygen saturation Highly favorable High specificity for identifying children who will not fail treatment Objective measurement but inter-provider agreement levels unknown
Later indicator decreases sensitivity for identifying children who will fail treatment at the community-level Robust, precise, low-cost point-of-care instrument needed
  Likely costly to implement and sustain
High blood lactate levels Unfavorable Low specificity for identifying children who will not fail treatment Point-of-care tool appropriate for community use not available, likely costly
Very late indicator decreases sensitivity for identifying children who will fail treatment at the community-level  
Moderate malnutrition Highly favorable Mid-range sensitivity and specificity which likely improves greatly in combination with other indicators High feasibility since measurement tools simple and accurate
High positive predictive value  
HIV-affected Minimally favorable Geographically limited in relevancy (e.g. primarily in eastern and southern Africa) Low feasibility since difficult to obtain HIV status at community-level (e.g. stigma)
High positive predictive value  
  1. HIV: Human Immunodeficiency Virus