Original articleSystematic Review of the Diagnostic Accuracy of C-Reactive Protein to Detect Bacterial Infection in Nonhospitalized Infants and Children with Fever
Section snippets
Methods
Because clinical assessment and prior diagnostic testing may change the spectrum of patients being assessed and therefore the diagnostic accuracy of a test,8 we limited this review to studies conducted in children who came to medical attention initially with complaint of fever. Studies that included children who had been admitted to hospital (other than in an emergency department observational ward) were excluded from the review.
We included studies that compared a blood or serum CRP measurement
Study Characteristics
The search retrieved 1770 potentially relevant titles and abstracts. Of these, 10 studies assessing a total of 2046 participants met the inclusion criteria for the review. All of the studies were conducted in emergency departments. 36 studies examining the diagnostic accuracy of CRP in children admitted to hospital were excluded. Characteristics of the studies investigating CRP for the identification of serious bacterial infection and for the differentiation of bacterial and nonbacterial/viral
Discussion
We conducted a systematic review of studies assessing the diagnostic accuracy of CRP for the diagnosis of bacterial infections in children initially evaluated because of fever. The results indicate that CRP is of moderate value for ruling out serious bacterial infection in a child with a fever but is of limited value for ruling out all bacterial infections. The diagnostic accuracy of the test for all bacterial infections is limited by the significant overlap in CRP values for children with
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Supported by a University of Queensland New Staff Start-up Grant. The funding source had no involvement in the conduct of this study.