Sudden infant death syndrome diagnostic study of choice

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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).

Diagnostic 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).
• 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:
  • An autopsy
  • Scene investigation and circumstances of the death
  • Exploration of the medical history of the infant and family

Apparent Life-Threatening Events (ALTEs) may be helpful in evaluating for SIDS:

• ALTEs can be found approximately in 1 of 400 infants

• ALTEs incules apneic episodes along with changes in the following:
  • Skin colour
  • Cyanosis
  • Pallor
  • Erythema
  • Muscle tone
  • Choking if suspected, evaluate by doing:
    • Barium studies
    • Observation
  • Gasping
  • Anemia if suspected, evaluate by doing CBC
  • Apnea if suspected, evaluate by doing:
    • Continuous pulse oximetry
    • Sleep study
  • Long QT syndrome if suspected, evaluate by doing Electrocardiography (ECG)
  • If suspected any upper respiratory problems like bronchiolitis, pertussis, or respiratory syncytial virus (RSV) do the following to confirm:
    • Chest radiography
    • Pulse oximetry
    • Respiratory syncytial virus
    • Pertussis culture
  • Gastroesophageal reflux disease (GERD) if suspected, evaluate by doing:
    • Barium studies
    • Radioisotope scan

OR

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]

Test	Sensitivity	Specificity
Test 1	...%	...%
Test 2	...%	...%

[Name of test with higher sensitivity and specificity] is the preferred investigation based on the sensitivity and specificity

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].