A5V4d

Feverish illness in children
Number
of
studies
62
Number
of
children
Sensitivity
(95%
confidence
interval)
Specificity
(95%
confidence
interval)
Reaching for objects (severely impaired)
For detecting serious bacterial infection
1
(Berger,
1996)
Lethargy
138 30 (15 to
46) a
For detecting serious bacterial infection
1 (Shin,
2009)
1
(Ghotbi,
2009)
221 17 (6 to 29)
a
254 42 (14 to
70) a
For detecting bacteraemia
1
(Crocker,
1985)
201 14 (1 to 27)
a
90 (85 to
96) a
72 (65 to
79) a
95 (92 to
97) a
78 (72 to
84) a
Positive
predictive
value
(95%
confidence
interval)
50 (28 to
72) a
13 (4 to 22)
a
28 (7 to 48)
a
10 (1 to 18)
a
Negative
predictive
value
(95%
confidence
interval)
81 (73 to
88) a
78 (72 to
85) a
97 (95 to
99) a
85 (79 to
90) a
Positive
likelihood
ratio
(95%
confidence
interval)
3.2 (1.5 to
7.0) a
0.6 (0.3 to
1.2) a
7.8 (3.3 to
18.2) a
0.7 (0.3 to
1.7) a
NC Not calculable
a Calculated by a member of the technical team at the NCC-WCH based on results reported in the study
Table 5.8 GRADE profile for evaluation of no smile and/or abnormal cry
Number
of
studies
Cry
Number
of
children
Sensitivity
(95%
confidence
interval)
For detecting serious bacterial infection
1 (Craig,
2010)
15781 43 (40 to
45) a
For detecting bacteraemia
1 (Crain,
1982)
Abnormal cry
Specificity
(95%
confidence
interval)
68 (67 to
68) a
Positive
predictive
value (95%
confidence
interval)
Negative
predictive
value (95%
confidence
interval)
9 (9 to 10) a 94 (93 to
94) a
Positive
likelihood
ratio
(95%
confidence
interval)
1.3 (1.2 to
1.4) a
Negative
likelihood
ratio
(95%
confidence
interval)
0.8 (0.6 to
1.0) a
1.2 (1.0 to
1.4) a
0.6 (0.4 to
1.0) a
1.1 (0.9 to
1.3) a
Negative
likelihood
ratio
(95%
confidence
interval)
0.9 (0.8 to
0.9) a
175 NR b NR b NR b NR b NR b NR b Low
For detecting bacteraemia
1
(Pantell,
2004)
3066 NR c NR c NR c NR c NR c NR c Low
CI confidence interval, NR not reported, OR odds ratio, P probability
a Calculated by a member of the technical team at the NCC-WCH based on results reported in the study
b Text in the study paper stated that crying is not significantly associated with bacteraemia
c Adjusted OR 2.23 (95% CI 1.16 to 4.29), P < 0.02
Quality
Low
Low
Very
low
Low
Quality
Low