SynthesisArchives of disease in childhood2020
Individual participant data validation of the PICNICC prediction model for febrile neutropenia.
Synthesis in Archives of disease in childhood, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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.
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Who cites it
5 citing papers in PubMed.
- Early clinical determinants of adverse outcomes in paediatric febrile neutropenia: a prospective cohort study.Frontiers in oncology · 2026Article
- Predicting Bloodstream Infection in Pediatric Post-Transfusion Febrile Neutropenia: Development of a Simple Bedside Risk Score.Children (Basel, Switzerland) · 2025Article
- Internal evaluation of risk stratification tool using serial procalcitonin and clinical risk factors in pediatric febrile neutropenia: The non-interventional, single institution experience prior to clinical implementation.Pediatric hematology and oncology · 2023Article
- Optimising Antimicrobial Selection and Duration in the Treatment of Febrile Neutropenia in Children.Infection and drug resistance · 2021Review
- Re-evaluating and recalibrating predictors of bacterial infection in children with cancer and febrile neutropenia.EClinicalMedicine · 2020Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundRisk-stratified approaches to managing cancer therapies and their consequent complications rely on accurate predictions to work effectively. The risk-stratified management of fever with neutropenia is one such very common area of management in paediatric practice. Such rules are frequently produced and promoted without adequate confirmation of their accuracy.
methodsAn individual participant data meta-analytic validation of the 'Predicting Infectious ComplicatioNs In Children with Cancer' (PICNICC) prediction model for microbiologically documented infection in paediatric fever with neutropenia was undertaken. Pooled estimates were produced using random-effects meta-analysis of the area under the curve-receiver operating characteristic curve (AUC-ROC), calibration slope and ratios of expected versus observed cases (E/O).
resultsThe PICNICC model was poorly predictive of microbiologically documented infection (MDI) in these validation cohorts. The pooled AUC-ROC was 0.59, 95% CI 0.41 to 0.78, tau
conclusionThis meta-analysis shows the PICNICC model should not be used at admission to predict MDI. Further work should focus on validating alternative prediction models. Validation across multiple cohorts from diverse locations is essential before widespread clinical adoption of such rules to avoid overtreating or undertreating children with fever with neutropenia.
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