A5V4d

Table 5.9 GRADE profile for evaluation of irritability
Number
of
studies
Irritability
Number
of
children
Sensitivity
(95%
confidence
interval)
For detecting serious bacterial infection
1 (Shin,
2009)
221 34 (20 to
49) a
For detecting bacteraemia
1 (Crain,
1982)
1
(Crocker,
1985)
Specificity
(95%
confidence
interval)
63 (56 to
70) a
Positive
predictive
value
(95%
confidence
interval)
18 (10 to
27) a
Clinical assessment of the child with fever
Negative
predictive
value
(95%
confidence
interval)
80 (73 to
87) a
Positive
likelihood
ratio
(95%
confidence
interval)
0.9 (0.6 to
1.5) a
Negative
likelihood
ratio
(95%
confidence
interval)
1.0 (0.8 to
1.3) a
175 NR b NR b NR b NR b NR b NR b Low
201 64 (47 to
82) c
For detecting urinary tract infection
1
(Morris,
2007)
55 (48 to
62) c
19 (11 to
27) c
91 (85 to
96) c
1.4 (1.0 to
2.0) c
0.7 (0.4 to
1.1) c
98 NR d NR d NR d NR d NR d NR d Low
For detecting bacterial meningitis
1
(Ghotbi,
2009)
254 58 (30 to
86) c
86 (82 to
90) c
For detecting viral meningitis or non-specific meningitis
1
(Gomez,
2012)
309 24 (15 to
32) c
78 (72 to
84) c
17 (6 to 29)
c
34 (23 to
45) c
98 (96 to
100) c
68 (62 to
74) c
NR not reported
a The selection criteria for including children in the study were not clearly described.
b Text in the paper stated that irritability is not significantly associated with bacteraemia.
4.2 (2.3 to
7.3) c
1.1 (0.7 to
1.7) c
c Calculated by a member of the technical team at the NCC-WCH based on results reported in the study.
d Text in the paper stated that irritability is not predictive of urinary tract infection.
Table 5.10 GRADE profile for evaluation of decreased consciousness/coma
Number
of
studies
Number
of
children
Sensitivity
(95%
confidence
interval)
Decreased consciousness
For detecting serious bacterial infection
1
(Bleeker,
2001)
Specificity
(95%
confidence
interval)
231 3 (1 to 6) a 91 (84 to
99) a
Positive
predictive
value
(95%
confidence
interval)
55 (25 to
84) a
Negative
predictive
value
(95%
confidence
interval)
24 (18 to
30) a
Positive
likelihood
ratio
(95%
confidence
interval)
0.4 (0.1 to
1.3) a
0.5 (0.2 to
0.9) c
1.0 (0.9 to
1.1) c
Negative
likelihood
ratio
(95%
confidence
interval)
1.1 (1.0 to
1.1) a
Quality
Low
Low
Low
Low
Quality
Very
low
63