Diagnostic testing for evaluation of brief resolved unexplained events.

Area of Science:

• Pediatric Emergency Medicine
• Clinical Diagnostics
• Infant Health

Background:

• Brief Resolved Unexplained Events (BRUEs) are a clinical concern in infants.
• Previous studies suggested limited utility of diagnostic testing for BRUEs.
• A need exists to evaluate diagnostic test yield in a larger, multicenter cohort.

Purpose of the Study:

• To determine the diagnostic yield of testing in infants presenting with BRUE.
• To assess the contribution of laboratory, imaging, and ancillary tests to final diagnoses.
• To evaluate testing utility in infants meeting American Academy of Pediatrics (AAP) higher-risk criteria.

Main Methods:

• Retrospective analysis of a multicenter cohort of infants < 1 year old.
• Inclusion criteria based on validated administrative data algorithm for BRUEs.
• Chart review to confirm diagnoses, risk criteria, and test contribution.

Main Results:

• Of 2036 infants, 45.3% received an explanatory diagnosis.
• Diagnostic tests supported the final diagnosis in only 3.2% of patients.
• Laboratory and imaging tests contributed to diagnoses in 1.1% and 1.5% of cases, respectively.

Conclusions:

• Diagnostic testing for BRUEs, including higher-risk infants, has low diagnostic yield.
• Current testing strategies rarely explain BRUEs.
• Further research should focus on specific, at-risk infant populations.