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‘Decision tree’ may facilitate intussusception diagnosis

Weihmiller SN. Pediatrics. 2011;127:e296-3303.

Looking at certain diagnostic markers, such as age, abnormal X-ray findings and gastrointestinal events, may help determine whether a child has intussusception, according to results of a study published online.

Sarah Weihmiller, MD, and colleagues from Children’s Hospital in Boston reviewed data on 38 patients with intussusception. The researchers collected data via a form before they conducted any imaging analysis.

The median age of the infants was 21.1 months, and about 60% were boys. The researchers noted that male sex, age older than 6 months, lethargic presentation and having abnormal X-rays were all predictors of intussusception.

The researchers then used this information to create a “decision tree” to guide their diagnosis and found that a decision tree “based on the results of an abdominal X-ray (negative or positive), age (≤5 or >5 months), diarrhea (present or absent), and bilious emesis (present or absent) had the best test performance (sensitivity: 97%; 95% CI, 86-100).”

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