A5V4d

Number of
studies
1
(Stathakis,
2007)
Clinical assessment of the child with fever
Height of fever Effect Quality
With serious bacterial
illness/infection (SBI) (°C,
mean)
Without SBI (°C, mean) P value
39.0 (SD 0.9) 38.8 (SD 1.0) P = 0.80 Moderate
For detecting meningococcal disease
1 (Nielsen,
2001)
Median 40 (IQR/range not
reported)
Median 39 (IQR/range not
reported)
For detecting pneumonia, urinary tract infection, bacterial meningitis, or bacteraemia
1
(Rudinsky,
2009)
P < 0.01 High
103.3°F (SD 1.2) 103.2°F (SD 1.2) P = 0.26 Moderate
For detecting urinary tract infection
1 (Singhi,
1992)
38.8 (SD 0.1) 38.8 (SD 0.15) NR High
IQR interquartile range, NR not reported, P probability, SBI serious bacterial illness/infection, SD standard deviation
Table 5.27 GRADE profile for evaluation of bulging fontanelle
Number
of
studies
Number
of
children
Bulging fontanelle
Sensitivity
(95%
confidence
interval)
For detecting serious bacterial illness
1
(Bleeker,
2001)
Specificity
(95%
confidence
interval)
231 5 (2 to 9) a 90 (82 to
97) a
For detecting bacterial meningitis
1
(Ghotbi,
2009)
254 8 (0 to 24) a 100 (100 to
100) a
Positive
predictive
value
(95%
confidence
interval)
60 (35 to
85) a
100 (100 to
100) a
For detecting pneumonia, urinary tract infection, or bacteraemia
1 (Craig,
2010)
12807 1 (0 to 1) a 100 (100 to
100) a
19 (7 to 31)
a
Negative
predictive
value
(95%
confidence
interval)
24 (18 to
30) a
96 (93 to
98) a
93 (92 to
93) a
Positive
likelihood
ratio
(95%
confidence
interval)
0.5 (0.2 to
1.4) a
Negative
likelihood
ratio
(95%
confidence
interval)
1.1 (1.0 to
1.2) a
NC 0.9 (0.8 to
1.1) a
3.0 (1.4 to
6.5) a
NC Not calculable
a Calculated by a member of the technical team at the NCC-WCH based on results reported in the study
1.0 (1.0 to
1.0) a
Quality
Very
low
Low
Low
79