Evaluation of a gastroenteritis severity score for use in outpatient settings

The objective of this study was to evaluate the internal reliability, construct validity, and ease of administration of a gastroenteritis disease severity score, the modified Vesikari score (MVS), which does not require in-person assessment. The MVS was created by replacing 1 variable (percent dehydration) in the original score with the need for future health care visits. We used the MVS to assess the global severity of disease in a cohort of children 3 to 48 months of age with acute gastroenteritis who were evaluated in 1 of 11 participating pediatric emergency departments. In this prospective study, caregivers recorded symptoms at home in a diary and reported the results via telephone at follow-up evaluation 14 days later. To evaluate internal reliability, we examined correlations between the items included in the score. Construct validity was evaluated by assessing the correlation between the total score and other proxy outcomes of disease severity, MVS distribution, and consistency between sites. A total of 455 children were enrolled, and 415 were successfully contacted for follow-up evaluation. Internal reliability was acceptable, with Cronbach's alpha of 0.59. Disease severity was correlated with day care (P = .01) and work (P = .002) absenteeism. The MVS was normally distributed, and mean scores did not differ between the 11 sites. The MVS seems to measure effectively the global severity of disease in a cohort of children with acute gastroenteritis. These data support the use of the MVS as an outcome measure in future clinical trials.