A5V4d

Feverish illness in children
Number of
studies
118
Number of
children
Sensitivity
(95%
confidence
interval)
Specificity
(95%
confidence
interval)
Detection of serious illness using heart rate above 50 th centile
1 (Brent,
2011)
Tachycardia
1 (Brent,
2011)
1360 72.5 (58.3
to 84.1)
1360 66.7 (52.1
to 79.2)
48.6 (45.7 to
51.5)
59.2 (56.3 to
62.0)
Positive likelihood
ratio
(95% confidence
interval)
Negative likelihood
ratio
(95% confidence
interval)
Quality
1.3 (0.58 to 3.1) 0.64 (0.28 to 1.5) Low
1.5 (0.67 to 3.4) 0.65 (0.29 to 1.46) Low
Table 5.55 GRADE profile for the sensitivity of cut-offs defined by heart rate centiles for detecting meningococcal
septicaemia of various degrees of severity in 325 children presenting to hospital with meningitis
Number of
studies
Total
number of
children
Sensitivity
(95% confidence interval)
All children with
meningococcal septicaemia
Detection of serious illness using heart rate above 97 th centile
Children with severe disease
on admission
1 (Brent, 2011) 325 11.0 (7.7 to 15.1) 17.9 (10.2 to 28.3) Low
Detection of serious illness using heart above 90 th centile
1 (Brent, 2011) 325 27.8 (22.8 to 33.2) 38.5 (27.7 to 50.2) Low
Detection of serious illness using heart rate above 75 th centile
1 (Brent, 2011) 325 49. (43.4 to 55.0) 61.5 (49.8 to 72.3) Low
Detection of serious illness using heart rate above 50 th centile
1 (Brent, 2011) 325 73.9 (68.5 to 78.8) 84.6 (74.7 to 91.8) Low
Detection of serious illness using heart rate below 50 th centile
1 (Brent, 2011) 325 26.1 (21.2 to 31.5) 15.4 (8.2 to 25.3) Low
Table 5.56 GRADE findings for evaluation of elevated heart rate
Quality
Number of studies Number of children Effect Quality
Tachycardia
Total Children with serious
bacterial infection (SBI)
Thompson, 2009 691 191 of 307 compared to
160 of 384
Relative
(95%
confidence
interval)
Absolute
(95%
confidence
interval)
2.3 (1.7 to 3.1) - Low