Bouza et al developed the NOVA score to evaluate a patient with enterococcal bacteremia. This can help to identify a patient who may require transesophageal echocardiography (TEE). The authors are from multiple hospitals in Spain.
Patient selection: enterococcal bacteremia
Outcome: infective endocarditis (OE)
Parameters:
(1) N - number of positive blood cultures
(2) O - origin of bacteremia unknown
(3) V - valvular disease, past history
(4) A - auscultation of a heart murmur
Parameter
Finding
Points
number of positive blood cultures
3 of 3, or majority if more than 3 cultures taken
5
other
0
origin
unknown
4
known
0
valvular disease
absent
0
present
2
heart murmur
absent
0
present
1
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 12
• A score >= 4 was 100% sensitive but only 29% specific (many false positives).
• A patient with a score 0 to 3 would not be a candidate for transesophageal echocardiography unless there are other indications.
Performance:
• The area under the ROC curve is 0.83.
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