Diagnostic Accuracy of the Modified Vesikari Score for Predicting Severe Acute Gastroenteritis in Children: A Prospective Diagnostic Accuracy Study

<title>Abstract</title> <p> <italic> <bold>Background:</bold> </italic> <italic>Acute gastroenteritis remains one of the leading causes of morbidity among children. The Modified Vesikari Score (MVS) has been proposed as a clinical tool for assessing disease severity; however, evidence regarding its diagnostic accuracy in primary referral hospitals remains limited</italic> ^{<italic>1-3</italic>} <italic>. this research to evaluate the diagnostic accuracy of the Modified Vesikari Score in predicting severe acute gastroenteritis among children presenting to a type D hospital.</italic> <italic> <bold>Methods:</bold> </italic> <italic>A prospective diagnostic accuracy study was conducted at Candi Umbul Regional General Hospital. Children aged 1–59 months presenting with acute gastroenteritis were enrolled consecutively. The Modified Vesikari Score was assessed at presentation and compared with the reference standard. Receiver operating characteristic (ROC) analysis was performed to determine the discriminative ability of the score. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and likelihood ratios were calculated.</italic> <italic> <bold>Results:</bold> </italic> <italic>A total of 70 children were included in the analysis. The ROC analysis demonstrated excellent discriminative performance with an area under the curve (AUC) of 0.975 (95% CI 0.927–1.000). The Modified Vesikari Score showed a sensitivity of 83.3% and specificity of 12.5%. The positive predictive value was 41.7%, while the negative predictive value was 50.0%. The positive and negative likelihood ratios were 0.95 and 1.33, respectively.</italic> <italic> <bold>Conclusion:</bold> </italic> <italic>The Modified Vesikari Score demonstrated excellent overall discrimination based on ROC analysis. However, its low specificity limits its use as a stand-alone diagnostic tool. The score may be useful as an initial screening instrument and should be interpreted together with clinical assessment and supporting investigations.</italic> </p>