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Description

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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