Disability after encephalitis: development and validation of a new outcome score

Area of Science:

• Pediatric Neurology
• Infectious Diseases
• Disability Assessment

Background:

• Japanese encephalitis (JE) poses a significant threat to children's neurological health.
• Assessing long-term disability and dependency after JE is crucial for patient management.
• Existing assessment tools may lack simplicity or comprehensive evaluation.

Purpose of the Study:

• To develop and validate a straightforward tool for assessing disability severity in children post-Japanese encephalitis.
• To determine the tool's ability to predict likely dependency in affected children.

Main Methods:

• A 15-item questionnaire-based outcome score was developed through literature review, expert consultation, and pilot testing.
• The score was applied to 100 children in Malaysia and 95 in India, including JE patients and controls.
• Inter- and intra-observer variability and agreement with clinical assessment were evaluated.

Main Results:

• Excellent inter-observer (Kappa 0.786-0.942) and intra-observer (Kappa 0.902-1.000) agreement was achieved.
• The tool demonstrated high sensitivity (100%) and specificity (93.8%-98.4%) in identifying dependent children.
• Agreement between the new score and clinical assessment was strong (Kappa 0.762-0.906).

Conclusions:

• The developed tool is simple to use for assessing disability after Japanese encephalitis.
• The outcome score shows good correlation with clinical assessments, aiding in dependency prediction.