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Management by the paediatric specialist
Figure 8.1 Plot of all reported sensitivities and specificities for PCT and CRP (1a-c Andreola 2007; 2a-c Hsiao
2006; 3 Guen; 4 Maniaci 2008; 5 Mazano; 6 Pulliam 2001; 7 Isaacman; 8 Gomez; 9 Berger 1996; 10a-b
Thayyil 2005; 11 Lacour 2001; 12 Galetto-Lacour 2003; 13 Olaciregui 2009; 14 Pratt 2007; 15 - Luaces-
Cubells, 2012 ; 16 - Woelker, 2012).
Next, a meta-analysis was undertaken for each test. In order to reduce bias only the eight studies that
directly compared PCT and CRP were included and a single point estimate from each study. The
results of these are shown in Table 8.4. These show that both tests predict a high area under curve
(greater than 0.8) on the ROC curve, with a figure higher than 0.8 suggesting a useful test, and only
small differences between the tests. The summary sensitivity results show both tests are moderately
useful, although PCT performs slightly better. The summary specificity result shows both tests have
moderate specificity, with PCT performing slightly better. However, the confidence intervals around
these point estimates range from low to high predictive value, which suggests uncertainty in the
findings. In addition, there was a high level of heterogeneity between studies in terms of how
conditions were classified as serious or not and the setting where the study was undertaken, which
limits the use of these results.
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2013 Update