Gastroenteritis is a viral or bacterial disease caused by the consumption of contaminated food and water. The most common pathogens causing gastroenteritis are norovirus, rotavirus, E.Coli, and  Salmonella. The study was conducted to assess the diagnostic accuracy of the Clinical Dehydration Scale (CDS) (1 month-5-year-old), WHO scale (1 month-3-year-old), and the Gorelick scale (1 month-5-year-old) in evaluating the degree of dehydration in children with acute gastroenteritis. The three scales are based on general conditions, eye moisture, tears, mucous membrane, etc.

In the study, using percentage loss of body weight three databases, two registers of clinical trials, and several reference lists were used to search for diagnostic accuracy studies in children with acute gastroenteritis. Ten such case studies were included and analyzed.  The outcomes were recorded in terms of sensitivity, specificity, positive likelihood ratio, and negative likelihood ration

It was found that the CDS showed poor systemic accuracy percentages in detecting the presence of dehydration (3-6%) or no (less than 3%). In high-income nations, the CDS provided a bigger margin in predicting positive dehydration likelihood (+ LR-3.9-11.9) by more than 6%. But it showed a limited evaluation of negative likelihood in the range of 0.55-0.71 while in low-income nations, CDS showed limited value in assessing the dehydration diagnostics. Meanwhile, the WHO Scale no or a limited number in determining dehydration in children with diarrhea. Also, the cases included in the study were not able to confirm the correctness of the Gorelick Scale. Conclusively, it can be summarised that WHO Scale and Gorelick Scale are not useful in assessing the degree of dehydration in comparison to the CDS. But, the CDS can only be used in diagnosing dehydration due to gastroenteritis in high-income countries.   

Falszewska A et al., Arch Dis Child. 2018 Apr;103(4):383-388. doi: 10.1136/archdischild-2017-313762.