A5V4d

Feverish illness in children
Table 5.5 GRADE profile for evaluation of ‘appears ill to a healthcare professional or parent/carer’
Number
of
studies
58
Number
of
children
Sensitivity
(95%
confidence
interval)
Specificity
(95%
confidence
interval)
Positive
predictive
value
(95%
confidence
interval)
Negative
predictive
value
(95%
confidence
interval)
Positive
likelihood
ratio
(95%
confidence
interval)
At least mildly unwell (includes mildly unwell, moderately unwell and very unwell)
For detecting urinary tract infection, pneumonia or bacteraemia
1 (Craig,
2010)
12807 74 (72 to
77) a
42 (41 to
43) a
9 (9 to 10) a 95 (95 to
96) a
1.3 (1.2 to
1.3) a
Negative
likelihood
ratio
(95%
confidence
interval)
0.6 (0.5 to
0.7) a
At least moderately ill or moderately unwell (includes moderately ill/unwell and very ill/unwell)
For detecting serious bacterial infection
1
(Berger,
1996)
138 58 (41 to
74) a
70 (61 to
78) a
37 (24 to
51) a
For detecting urinary tract infection, pneumonia or bacteraemia
1 (Craig,
2010)
12807 22 (20 to
25) a
For detecting urinary tract infection
1
(Newma
n, 2002)
1666 38 (30 to
45) a
For detecting occult infections
1
(Pantell,
2004)
Not well-appearing
92 (91 to
92) a
65 (62 to
67) a
17 (15 to
19) a
10 (8 to 13)
a
84 (76 to
92) a
94 (93 to
94) a
91 (89 to
92) a
1.9 (1.3 to
2.9) a
2.7 (2.4 to
3.0) a
1.1 (0.9 to
1.3) a
0.6 (0.4 to
0.9) a
0.8 (0.8 to
0.9) a
1.0 (0.8 to
1.1) a
3066 NC NC NC NC NC NC Low
For detecting serious bacterial infection
1
(Gomez,
2010)
Appears unwell
1018 26
(8 to 44) a
For detecting serious bacterial infection
1
(Nijuman
, 2012)
Poor appearance
96
(95 to 97) a
1255 1 (0 to 4) a 97 (96 to
98) a
For detecting serious bacterial infection
1 (Chen,
2009)
Ill appearance
135 35 (19 to
51) a
For detecting serious illness
1
(McCarth
y, 1985)
103 54 (35 to
73) a
82 (75 to
90) a
90 (83 to
96) a
13
(3 to 22) a
98
(97 to 99) a
6 (0 to 15) a 89 (88 to
91) a
40 (22 to
58) a
64 (44 to
84) a
79 (71 to
87) a
85 (77 to
93) a
6.2
(2.9 to 13.1)
a
0.6 (0.1 to
2.5) a
2.0 (1.1 to
3.6) a
5.2 (2.5 to
10.9) a
0.8
(0.6 to 1.0) a
1.0 (1.0 to
1.0) a
0.8 (0.6 to
1.0) a
0.5 (0.3 to
0.8) a
Quality
Low
Low
Low
Low
Very
low
Very
low
Very
low
Very
low