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BackgroundThere is no consensus on how to best quantify disease severity in infants with respiratory syncytial virus (RSV) and/or bronchiolitis; this lack of a sufficiently validated score complicates the provision of clinical care and, the evaluation of trials of therapeutics and vaccines. The ReSVinet score appears to be one of the most promising; however it is too time-consuming to be incorporated into routine clinical care. We aimed to develop and externally validate simplified versions of this score.MethodsData were used from a multinational (Netherlands, Spain & United Kingdom) multicentre case-control observational study of infants with RSV to develop simplified versions of the ReSVinet by conducting a grid search to determine the best combination of equally weighted parameters to maximise for the discriminative ability of the scores across a range of outcomes (hospitalisation, intensive care unit admission, ventilation requirement). Subsequently discriminative validity of the score for a range of secondary care outcomes was externally validated by conducting a secondary analysis of data collected in infants with respiratory infection from tertiary hospitals in Rwanda and Colombia.ResultsThree candidate simplified scores were identified using the development dataset; they were excellent (area under the receiver-operator characteristic curve [AUROC] >0.9) in the development dataset at discriminating for a range of outcomes, and their performance was not statistically significantly different to the original ReSVinet score despite having fewer parameters. In the external validation datasets, the simplified scores were moderate-excellent (AUROC 0.7-1) across a range of outcomes. In all outcomes, except for in a single dataset at predicting admission to the high dependency unit, they performed at least as well as the original ReSVinet score.ConclusionsThree promising candidate simplified scores were developed; however further external validation work in larger datasets, ideally from resource-limited settings needs to be conducted before any recommendation regarding their use.

Original publication




Journal article


The Journal of infectious diseases

Publication Date



Edinburgh Medical School, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK.