A5V4d

Feverish illness in children
Number
of
studies
84
Number
of
children
Increased vomiting
Sensitivity
(95%
confidence
interval)
For detecting urinary tract infection
1
(Newma
n, 2002)
1666 15 (9 to 20)
a
Diarrhoea and vomiting
For detecting serious bacterial infection
1
(Nijman,
2011)
Specificity
(95%
confidence
interval)
82 (80 to 84)
a
1255 6 (2 to 10) a 91 (89 to 92)
a
Mild gastrointestinal symptoms
For detecting serious bacterial infection
1 (Shin,
2009)
221
15 (4 to 25)
a
89 (84 to 94)
a
Positive
predictive
value
(95%
confidence
interval)
8 (5 to 11) a
Negative
predictive
value
(95%
confidence
interval)
90 (88 to
92) a
7 (2 to 12) a 89 (87 to
91) a
24 (7 to 41)
a
81 (76 to
87) a
Positive
likelihood
ratio
(95%
confidence
interval)
0.8 (0.6 to
1.2) a
0.6 (0.3 to
1.3) a
1.3 (0.6 to
3.1) a
Ci confidence interval, NR not reported, odds ratio
a Calculated by a member of the technical team at the NCC-WCH based on results reported in the study
b The paper reported: OR 0.76 (95% CI 0.26 to 2.18)
c The text in the paper stated that vomiting is not predictive of urinary tract infection
Table 5.33 GRADE profile for evaluation of abdominal pain
Number
of
studies
Number
of
children
Abdominal pain
Sensitivity
(95%
confidence
interval)
For detecting serious illness
1
(Nijman,
2011)
Specificity
(95%
confidence
interval)
1255 5 (1 to 8) a 97 (95 to 98)
a
For detecting urinary tract infection
1
(Morris,
2007)
Positive
predictive
value
(95%
confidence
interval)
13 (3 to 23)
a
Negative
predictive
value
(95%
confidence
interval)
90 (88 to
91) a
Positive
likelihood
ratio
(95%
confidence
interval)
1.3 (0.6 to
3.1) a
Negative
likelihood
ratio
(95%
confidence
interval)
1.0 (1.0 to
1.1) a
1.0 (1.0 to
1.1) a
1.0 (0.8 to
1.1) a
Negative
likelihood
ratio
(95%
confidence
interval)
1.0 (1.0 to
1.0) a
98 NR b NR b NR b NR b NR b NR b Low
NR Not reported
a Calculated by the NCC-WCH based on data reported in the study
b The text in the paper stated that abdominal pain is not predictive or urinary tract infection
Quality
Low
Very
low
Low
Quality
Very
low