To assess preventability of hospital-onset bacteremia and fungemia (HOB), we developed and evaluated a structured rating guide accounting for intrinsic patient and extrinsic healthcare-related risks.

HOB preventability rating guide was compared against a reference standard expert panel.

A 10-member panel of clinical experts was assembled as the standard of preventability assessment, and 2 physician reviewers applied the rating guide for comparison.

The expert panel independently rated 82 hypothetical HOB scenarios using a 6-point Likert scale collapsed into 3 categories: preventable, uncertain, or not preventable. Consensus was defined as concurrence on the same category among ≥70% experts. Scenarios without consensus were deliberated and followed by a second round of rating.

Two reviewers independently applied the rating guide to adjudicate the same 82 scenarios in 2 rounds, with interim revisions. Interrater reliability was evaluated using the κ (kappa) statistic.

Expert panel consensus criteria were met for 52 scenarios (63%) after 2 rounds.

After 2 rounds, guide-based rating matched expert panel consensus in 40 of 52 (77%) and 39 of 52 (75%) cases for reviewers 1 and 2, respectively. Agreement rates between the 2 reviewers were 84% overall (κ, 0.76; 95% confidence interval [CI], 0.64–0.88]) and 87% (κ, 0.79; 95% CI, 0.65–0.94) for the 52 scenarios with expert consensus.

Preventability ratings of HOB scenarios by 2 reviewers using a rating guide matched expert consensus in most cases with moderately high interreviewer reliability. Although diversity of expert opinions and uncertainty of preventability merit further exploration, this is a step toward standardized assessment of HOB preventability.

Studies have shown that children with learning difficulties are likely to demonstrate a host of shared behavioral and emotional problems that affect their daily functioning.

The goal of this study was to examine profiles of behavioral and emotional problems in children at risk for Learning Disorders (LD) and Communication Disorders (COMM), without intellectual disabilities.

Data on the Child Behavior Checklist (CBCL) of 52 participants (4–12 years old) at-risk for LD and 52 age- and gender- matched participants at-risk for COMM were obtained from the archival records of a local outpatient child psychiatric clinic. For all CBCL scales, T scores ranging from 65 to 69 are in the borderline clinical range, whereas a T score of 70 and above are in the clinical range. T scores of below 65 are considered as non-clinical. For the purposes of this study, a T score of 65 and above for the CBCL syndromes indicated the problem to be of clinical concern.

A total of 51.9% of these children had at least one problem of clinical concern, with Attention Problems (LD: 36.5% vs. COMM: 17.3%), Social Problems (LD: 21.2% vs. COMM: 30.8%), and Withdrawn/Depressed (LD: 23.1% vs. COMM: 26.9%) syndromes being commonly reported. There were no significant differences between the 2 groups on the CBCL syndromes.

Findings from the study suggest that children with any form of learning difficulties demonstrate high prevalence of behavioral and emotional problems, suggesting possible comorbidities such as Attention Deficit Hyperactivity and Depression.