Sudden infant death syndrome diagnostic study of choice: Difference between revisions

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== Overview ==
== Overview ==
There is no single diagnostic test for the [[diagnosis]] of the [[sudden infant death syndrome]] ([[SIDS]]).
There is no single [[diagnostic]] test for the [[diagnosis]] of the [[sudden infant death syndrome]] ([[SIDS]]). [[Sudden infant death syndrome|SIDS]] is mostly diagnosed with the process of elimination of the other possible causes of the death in the [[infant]].


== Diagnostic Study of Choice ==
== Diagnostic Study of Choice ==
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=== Study of choice ===
=== Study of choice ===


* The big issue with [[sudden infant death syndrome]] (SIDS) is that there is no single diagnostic test for the diagnosis of the sudden infant death syndrome (SIDS).<ref name="pmid30035964">{{cite journal| author=Duncan JR, Byard RW| title=SIDS Sudden Infant and Early Childhood Death: The Past, the Present and the Future | journal= | year= 2018 | volume=  | issue=  | pages=  | pmid=30035964 | doi= | pmc= | url= }}</ref>
* The big issue with [[sudden infant death syndrome]] ([[Sudden infant death syndrome|SIDS]]) is that there is no single [[diagnostic]] test for the [[diagnosis]] of the [[sudden infant death syndrome]] ([[Sudden infant death syndrome|SIDS]]).<ref name="pmid30035964">{{cite journal| author=Duncan JR, Byard RW| title=SIDS Sudden Infant and Early Childhood Death: The Past, the Present and the Future | journal= | year= 2018 | volume=  | issue=  | pages=  | pmid=30035964 | doi= | pmc= | url= }}</ref>
* SIDS is mostly diagnosed with the process of elimination of the other possible causes of the death in the infant.
*[[Sudden infant death syndrome|SIDS]] is mostly diagnosed with the process of elimination of the other possible causes of the death in the [[infant]].
*Investigation of SIDS include the following:<ref name="pmid15700732">{{cite journal| author=Guffanti S, Grancini F, Scalfaro C, Podestà AF| title=[Sudden infant death syndrome (SIDS)]. | journal=Pediatr Med Chir | year= 2004 | volume= 26 | issue= 2 | pages= 96-104 | pmid=15700732 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15700732  }}</ref><ref name="pmid30035958">{{cite journal| author=Duncan JR, Byard RW| title=SIDS Sudden Infant and Early Childhood Death: The Past, the Present and the Future | journal= | year= 2018 | volume=  | issue=  | pages=  | pmid=30035958 | doi= | pmc= | url= }}</ref>
*Investigation of [[Sudden infant death syndrome|SIDS]] include the following:<ref name="pmid15700732">{{cite journal| author=Guffanti S, Grancini F, Scalfaro C, Podestà AF| title=[Sudden infant death syndrome (SIDS)]. | journal=Pediatr Med Chir | year= 2004 | volume= 26 | issue= 2 | pages= 96-104 | pmid=15700732 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15700732  }}</ref><ref name="pmid30035958">{{cite journal| author=Duncan JR, Byard RW| title=SIDS Sudden Infant and Early Childhood Death: The Past, the Present and the Future | journal= | year= 2018 | volume=  | issue=  | pages=  | pmid=30035958 | doi= | pmc= | url= }}</ref>
**An autopsy
**An [[autopsy]]
**Scene investigation and circumstances of the death
**Scene investigation and circumstances of the death
**Exploration of the [[medical history]] of the infant and family
**Exploration of the [[medical history]] of the [[infant]] and family


Apparent Life-Threatening Events (ALTEs) may be helpful in evaluating for SIDS:<ref name="pmid15723922">{{cite journal| author=Kiechl-Kohlendorfer U, Hof D, Peglow UP, Traweger-Ravanelli B, Kiechl S| title=Epidemiology of apparent life threatening events. | journal=Arch Dis Child | year= 2005 | volume= 90 | issue= 3 | pages= 297-300 | pmid=15723922 | doi=10.1136/adc.2004.049452 | pmc=1720328 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15723922  }}</ref>  
==== '''Apparent Life-Threatening Events''' (ALTEs) may be helpful in evaluating for [[Sudden infant death syndrome|SIDS]]:<ref name="pmid15723922">{{cite journal| author=Kiechl-Kohlendorfer U, Hof D, Peglow UP, Traweger-Ravanelli B, Kiechl S| title=Epidemiology of apparent life threatening events. | journal=Arch Dis Child | year= 2005 | volume= 90 | issue= 3 | pages= 297-300 | pmid=15723922 | doi=10.1136/adc.2004.049452 | pmc=1720328 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15723922  }}</ref><ref name="pmid15325403">{{cite journal| author=Gleeson M, Clancy RL, Cox AJ, Gulliver SA, Hall ST, Cooper DM| title=Mucosal immune responses to infections in infants with acute life threatening events classified as 'near-miss' sudden infant death syndrome. | journal=FEMS Immunol Med Microbiol | year= 2004 | volume= 42 | issue= 1 | pages= 105-18 | pmid=15325403 | doi=10.1016/j.femsim.2004.06.019 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15325403  }}</ref><ref name="pmid18280841">{{cite journal| author=Esani N, Hodgman JE, Ehsani N, Hoppenbrouwers T| title=Apparent life-threatening events and sudden infant death syndrome: comparison of risk factors. | journal=J Pediatr | year= 2008 | volume= 152 | issue= 3 | pages= 365-70 | pmid=18280841 | doi=10.1016/j.jpeds.2007.07.054 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18280841  }}</ref><ref name="pmid19817255">{{cite journal| author=Wasilewska J, Kaczmarski M| title=[Modifiable risk factors of sudden infant death syndrome (SIDS). The current guidelines for reducing the risk of SIDS]. | journal=Wiad Lek | year= 2009 | volume= 62 | issue= 1 | pages= 30-6 | pmid=19817255 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19817255  }}</ref><ref name="pmid10763531">{{cite journal| author=Poets CF| title=[Home monitoring of infants at risk of sudden infant death: suggestions for reconsideration of current practice]. | journal=Wien Klin Wochenschr | year= 2000 | volume= 112 | issue= 5 | pages= 198-203 | pmid=10763531 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10763531  }}</ref><ref name="DiMario2008">{{cite journal|last1=DiMario|first1=F. J.|title=Apparent Life-Threatening Events: So What Happens Next?|journal=PEDIATRICS|volume=122|issue=1|year=2008|pages=190–191|issn=0031-4005|doi=10.1542/peds.2008-1242}}</ref><ref name="pmid24427501">Kadivar M, Yaghmaie B, Allahverdi B, Shahbaznejad L, Razi N, Mosayebi Z (2013) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=24427501 Apparent life-threatening events in neonatal period: clinical manifestations and diagnostic challenges in a pediatric referral center.] ''Iran J Pediatr'' 23 (4):458-66. PMID: [https://pubmed.gov/24427501 24427501]</ref> ====


* ALTEs  can be found approximately in 1 of 400 infants   
* ALTEs  can be found approximately in 1 of 400 infants   


* ALTEs incules apneic episodes along with changes in the following:   
* ALTEs incules apneic episodes along with changes in the following:   
** Skin colour
**'''[[Skin colour]]''' changes which include:
** Cyanosis  
***'''[[Cyanosis]]'''
** Pallor  
***'''[[Pallor]]'''
** Erythema  
***'''[[Erythema]]'''
** Muscle tone  
**'''[[Muscle]] tone''' either increased or decreased
** Choking if suspected, evaluate by doing:
**'''[[Choking]]''' if suspected, evaluate by doing:
***Barium studies
***[[Barium|Barium studies]]
***Observation
***Observation
** Gasping  
** Gasping
** Anemia if suspected, evaluate by doing CBC  
**'''[[Anemia]]''' if suspected, evaluate by doing [[complete blood count]] ([[Complete blood count|CBC]])
** Apnea if suspected, evaluate by doing:   
**'''[[Apnea]]''' if suspected, evaluate by doing:   
*** Continuous pulse oximetry  
*** Continuous [[pulse oximetry]]
*** Sleep study   
*** Sleep study   
**Long QT syndrome if suspected, evaluate by doing Electrocardiography (ECG)
**'''[[Long QT syndrome]]''' if suspected, evaluate by doing [[electrocardiography]] ([[The electrocardiogram|ECG]])
**If suspected any upper respiratory problems like bronchiolitis, pertussis, or respiratory syncytial virus (RSV) do the following to confirm:
**If suspected any '''[[Upper respiratory tract|upper respiratory]] problems''' like [[bronchiolitis]], [[pertussis]], or [[respiratory syncytial virus]] ([[RSV]]) do the following to confirm:
***Chest radiography
***[[Chest radiography]]
***Pulse oximetry
***[[Pulse oximetry]]
***Respiratory syncytial virus  
***[[Respiratory syncytial virus]]
***Pertussis culture
***[[Pertussis]] culture
**Gastroesophageal reflux disease (GERD) if suspected, evaluate by doing:
**'''[[Gastroesophageal reflux disease]]''' ([[Gastroesophageal reflux disease|GERD]]) if suspected, evaluate by doing:
***Barium studies
***[[Barium]] studies
***Radioisotope scan
***[[Radioisotope scan|Radioisotope]] scan
**'''[[Infection]]''' if suspected, evaluate by doing:
***Blood gas analysis (BGA)
***Blood [[lactate]] level
***[[Complete blood count]] ([[Complete blood count|CBC]])
***[[Chest X-ray|Chest x-ray]]
***[[Lumbar puncture]] ([[LP]]) with [[cerebrospinal fluid]] analysis ([[CSF]])
***[[Electrolyte disturbance|Serum electrolytes]]
***[[Urinalysis]]


OR
<br />
 
The following result of [gold standard test] is confirmatory of [disease name]:
* [Result 1]
* [Result 2]
 
OR
 
[Name of the investigation] must be performed when:
* The patient presents with [symptom/sign 1], [symptom/sign 2], and [symptom/sign 3].
* A [name of test] is positive for [sign 1], [sign 2], and [sign 3] in the patient.
 
OR
 
[Name of the investigation] is the gold standard test for the diagnosis of [disease name].
 
OR
 
The diagnostic study of choice for [disease name] is [name of the investigation].
 
OR
 
There is no single diagnostic study of choice for the diagnosis of [disease name].
 
OR
 
There is no single diagnostic study of choice for the diagnosis of [disease name], but [disease name] can be diagnosed based on [name of the investigation 1] and [name of the investigation 2].
 
OR
 
[Disease name] is primarily diagnosed based on the clinical presentation.
 
OR
 
Investigations:
* Among the patients who present with clinical signs of [disease name], the [investigation name] is the most specific test for the diagnosis.
* Among the patients who present with clinical signs of [disease name], the [investigation name] is the most sensitive test for diagnosis.
* Among the patients who present with clinical signs of [disease name], the [investigation name] is the most efficient test for diagnosis.
 
==== The comparison of various diagnostic studies for [disease name] ====
{|
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! style="background: #4479BA; color: #FFFFFF; text-align: center;" | Test
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Sensitivity
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Specificity
|-
! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 1
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
|-
! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 2
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
|}
<small> [Name of test with higher sensitivity and specificity] is the preferred investigation based on the sensitivity and specificity</small>
 
===== Diagnostic results =====
The following finding(s) on performing [investigation name] is(are) confirmatory for [disease name]:
* [Finding 1]
* [Finding 2]
 
===== Sequence of Diagnostic Studies =====
The [name of investigation] must be performed when:
* The patient presented with symptoms/signs 1, 2, and 3 as the first step of diagnosis.
* A positive [test] is detected in the patient, to confirm the diagnosis.
 
OR
 
The various investigations must be performed in the following order:
* [Initial investigation]
* [2nd investigation]
 
=== Name of Diagnostic Criteria ===
 
'''It is recommended that you include the criteria in a table. Make sure you always cite the source of the content and whether the table has been adapted from another source.'''
 
[Disease name] is primarily diagnosed based on clinical presentation. There are no established criteria for the diagnosis of [disease name].
 
OR
 
There is no single diagnostic study of choice for [disease name], though [disease name] may be diagnosed based on [name of criteria] established by [...].
 
OR
 
The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
 
OR
 
The diagnosis of [disease name] is based on the [criteria name] criteria, which includes [criterion 1], [criterion 2], and [criterion 3].
 
OR
 
[Disease name] may be diagnosed at any time if one or more of the following criteria are met:
* Criteria 1
* Criteria 2
* Criteria 3
 
OR
 
'''IF there are clear, established diagnostic criteria'''
 
The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
 
OR
 
The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
 
OR
 
The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
 
OR
 
'''IF there are no established diagnostic criteria'''
 
There are no established criteria for the diagnosis of [disease name].


==References==
==References==

Latest revision as of 13:27, 28 May 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

There is no single diagnostic test for the diagnosis of the sudden infant death syndrome (SIDS). SIDS is mostly diagnosed with the process of elimination of the other possible causes of the death in the infant.

Diagnostic Study of Choice

Study of choice

Apparent Life-Threatening Events (ALTEs) may be helpful in evaluating for SIDS:[4][5][6][7][8][9][10]

  • ALTEs can be found approximately in 1 of 400 infants


References

  1. Duncan JR, Byard RW (2018). "SIDS Sudden Infant and Early Childhood Death: The Past, the Present and the Future". PMID 30035964.
  2. Guffanti S, Grancini F, Scalfaro C, Podestà AF (2004). "[Sudden infant death syndrome (SIDS)]". Pediatr Med Chir. 26 (2): 96–104. PMID 15700732.
  3. Duncan JR, Byard RW (2018). "SIDS Sudden Infant and Early Childhood Death: The Past, the Present and the Future". PMID 30035958.
  4. Kiechl-Kohlendorfer U, Hof D, Peglow UP, Traweger-Ravanelli B, Kiechl S (2005). "Epidemiology of apparent life threatening events". Arch Dis Child. 90 (3): 297–300. doi:10.1136/adc.2004.049452. PMC 1720328. PMID 15723922.
  5. Gleeson M, Clancy RL, Cox AJ, Gulliver SA, Hall ST, Cooper DM (2004). "Mucosal immune responses to infections in infants with acute life threatening events classified as 'near-miss' sudden infant death syndrome". FEMS Immunol Med Microbiol. 42 (1): 105–18. doi:10.1016/j.femsim.2004.06.019. PMID 15325403.
  6. Esani N, Hodgman JE, Ehsani N, Hoppenbrouwers T (2008). "Apparent life-threatening events and sudden infant death syndrome: comparison of risk factors". J Pediatr. 152 (3): 365–70. doi:10.1016/j.jpeds.2007.07.054. PMID 18280841.
  7. Wasilewska J, Kaczmarski M (2009). "[Modifiable risk factors of sudden infant death syndrome (SIDS). The current guidelines for reducing the risk of SIDS]". Wiad Lek. 62 (1): 30–6. PMID 19817255.
  8. Poets CF (2000). "[Home monitoring of infants at risk of sudden infant death: suggestions for reconsideration of current practice]". Wien Klin Wochenschr. 112 (5): 198–203. PMID 10763531.
  9. DiMario, F. J. (2008). "Apparent Life-Threatening Events: So What Happens Next?". PEDIATRICS. 122 (1): 190–191. doi:10.1542/peds.2008-1242. ISSN 0031-4005.
  10. Kadivar M, Yaghmaie B, Allahverdi B, Shahbaznejad L, Razi N, Mosayebi Z (2013) Apparent life-threatening events in neonatal period: clinical manifestations and diagnostic challenges in a pediatric referral center. Iran J Pediatr 23 (4):458-66. PMID: 24427501

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