ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2007
Signs and symptoms for diagnosis of serious infections in children: a prospective study in primary care.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 81 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Validation of Vital Signs and Symptoms for the Diagnosis of Serious Infections in Children in a High Prevalent Setting: the Paediatric A&E.
Validation of a Vital Signs and Symptoms Decision Tree and the Effect of a Point-of- Care CRP Test, Oxygen Saturation, a Brief Intervention and a Parent Leaflet on Diagnosing, Antibiotic Prescribing Rate and Parental Satisfaction in Acutely Ill Children in Primary Care."
Using Video Transmission for Optimized Telephone Triage of Children With Fever at the Medical Helpline 1813 in Copenhagen, Denmark
Who cites it
81 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- The Role of Parental Concerns in the Recognition of Sepsis in Children: A Literature Review.Frontiers in pediatrics · 2019Pooled it
- Diagnostic value of signs, symptoms and diagnostic tests for diagnosing pneumonia in ambulant children in developed countries: a systematic review.NPJ primary care respiratory medicine · 2018Pooled it
- Duration of fever and serious bacterial infections in children: a systematic review.BMC family practice · 2011Pooled it
- Signs and symptoms in diagnosing acute myocardial infarction and acute coronary syndrome: a diagnostic meta-analysis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2008Pooled it
- Video triage in calls concerning children with fever at an out-of-hours medical helpline: a prospective quality improvement study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2023Trial
- Clinical prediction models for serious infections in children: external validation in ambulatory care.BMC medicine · 2023Trial
- How parents express their worry in calls to a medical helpline: a mixed methods study.BMC primary care · 2022Trial
- Causes of fever in primary care in Southeast Asia and the performance of C-reactive protein in discriminating bacterial from viral pathogens.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2020Trial
- Point-of-care CRP matters: normal CRP levels reduce immediate antibiotic prescribing for acutely ill children in primary care: a cluster randomized controlled trial.Scandinavian journal of primary health care · 2018Trial
- Reducing inappropriate antibiotic prescribing for children in primary care: a cluster randomised controlled trial of two interventions.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018Trial
- Should all acutely ill children in primary care be tested with point-of-care CRP: a cluster randomised trial.BMC medicine · 2016Trial
- Trial
- Trial
- Understanding parents' decisions to seek care for children with serious bacterial infections: a qualitative study.BMJ open · 2026Article
- Parental Ability to Identify Severe Illnesses in Their Children.JAMA network open · 2026Article
- Rapid diagnostics to improve antibiotic prescribing in children: one piece of a much larger jigsaw.The Lancet regional health. Europe · 2025Article
- Assessing children who are acutely ill in general practice using the National PEWS and LqSOFA clinical scores: a retrospective cohort study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Behavioural impact of antibiotic stewardship in children in primary care: interviews with GPs and parents.JAC-antimicrobial resistance · 2024Article
- A prospective study to evaluate the contribution of the pediatric appendicitis score in the decision process.BMC pediatrics · 2024Article
- Pre-hospital symptoms associated with acute bacterial meningitis differs between children and adults.Scientific reports · 2023Article
21 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSerious infections in children (sepsis, meningitis, pneumonia, pyelonephritis, osteomyelitis, and cellulitis) are associated with considerable mortality and morbidity. In children with an acute illness, the primary care physician uses signs and symptoms to assess the probability of a serious infection and decide on further management.
aimTo analyse the diagnostic accuracy of signs and symptoms, and to create a multivariable triage instrument. DESIGN OF STUDY: A prospective diagnostic accuracy study.
settingPrimary care in Belgium.
methodChildren aged 0-16 years with an acute illness for a maximum of 5 days were included consecutively. Signs and symptoms were recorded and compared to the final outcome of these children (a serious infection for which hospitalisation was necessary). Accuracy was analysed bivariably. Multivariable triage instruments were constructed using classification and regression tree (CART) analysis.
resultsA total of 3981 children were included in the study, of which 31 were admitted to hospital with a serious infection (0.78%). Accuracy of signs and symptoms was fairly low. Classical textbook signs (meningeal irritation impaired peripheral circulation) had high specificity. The primary classification tree consisted of five knots and had sensitivity of 96.8% (95% confidence interval [CI] = 83.3 to 99.9), specificity 88.5% (95% CI = 87.5 to 89.5), positive predictive value 6.2% (95% CI = 4.2 to 8.7), and negative predictive value 100.0% (95% CI = 99.8 to 100.0), by which a serious infection can be excluded in children testing negative on the tree. The sign paramount in all trees was the physician's statement 'something is wrong'.
conclusionSome individual signs have high specificity. A serious infection can be excluded based on a limited number of signs and symptoms.
Indexed as
Identifiers
17727746PMC2099636What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.