In the emergency department (ED) setting, unstructured clinician suspicion did not reliably spot serious bacterial infections in febrile infants aged 60 days or younger, according to a prospective analysis of over 4,500 infants. Details of the analysis are as follows:

• Researchers evaluated ED clinicians’ ability to detect serious bacterial infections (SBIs), including invasive infections, comparing 2 detection methods.
• The Yale Observation Scale score generated a sensitivity rate of only 11.6% and a negative predictive value of 90.4%.
• When clinicians relied on their unstructured suspicion of infection, SBIs occurred in 6.4% of infants who were rated as having less than a 1% likelihood of such an infection.