Predicts later severe sickle-cell disease from events in the first two years of life.
The Sickle Cell — Risk of Severe Disease (Miller) is a haematology scoring tool used in paediatric practice. Predicts later severe sickle-cell disease from events in the first two years of life. It scores 3 criteria and interprets the total across 3 bands, so the number always arrives with the severity it implies rather than on its own. In PediAid each criterion is shown as a labelled option with the weight it carries, so the total can be checked rather than taken on trust.
3. They are Dactylitis (hand-foot syndrome) before 1 year of age; Haemoglobin < 7 g/dL (baseline, steady state); Leucocytosis in the absence of infection.
The total is interpreted as: any score - Low risk: no predictors - low probability of severe disease in later childhood. Continue routine care: penicillin prophylaxis, vaccination, TCD screening; 1 risk factor or more - Intermediate: one predictor - intermediate risk. Maintain close follow-up and a low threshold for starting hydroxyurea; 2 risk factors or more - High risk: two or more predictors - high probability of severe disease (adverse outcome by age 10). Strongly consider early hydroxyurea and intensified monitoring.
No. It is a structured way to record and communicate severity. A clinician concerned about a child should act on that concern regardless of the total.
Derived in the Cooperative Study of Sickle Cell Disease infant cohort.
Yes. Score definitions are bundled with the PediAid app, so the score computes without a connection.