Evidence map›Paper›PMID 34138848›Full record

SynthesisPloS one2021

Symptomatic fever management in children: A systematic review of national and international guidelines.

Cari Green, Hanno Krafft, Gordon Guyatt, David Martin

Registry-linked trialOpen access · goldAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05189236 (The Effect of Cold Steam Application on Body Temperature in Fever Management in Children With Febrile Neutropenia), which is not on this map. Cited by 21 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 2 pooled it
3.8field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT05189236 nacompletednot on this map

The Effect of Cold Steam Application on Body Temperature in Fever Management in Children With Febrile Neutropenia

TypeinterventionalSponsorAcibadem UniversityRan2021 to 2023Enrolled34ConditionsFeverArmsControl Group (Only Algorithm of Febrile Neutropenia Management), Experimental Group (Algorithm of Febrile Neutropenia Management+Cold Steam)
3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 48 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Trial
  4. Article
  5. Article
  6. Observational
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Review
  13. Article
  14. Fever in Sepsis Revisited: Is a Little Heat What We Need?Open forum infectious diseases · 2025
    Review
  15. Review
  16. [Feverphobia: Frecuency and related factors associated]Revista de la Facultad de Ciencias Medicas (Cordoba, Argentina) · 2024
    Observational
  17. Article
  18. Review
  19. Article
  20. The Three W's of Acetaminophen In Children: Who, Why, and Which Administration Mode.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2023
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 2 countries.

Cari GreenGerhard Kienle Chair, Health Department, University of Witten/Herdecke, Herdecke, Germany.
Hanno KrafftGerhard Kienle Chair, Health Department, University of Witten/Herdecke, Herdecke, Germany.ORCID 0000-0002-8199-8874
Gordon GuyattDepartments of Health Research Methods, Evidence and Impact and Medicine at McMaster University, Hamilton, Canada.
David MartinGerhard Kienle Chair, Health Department, University of Witten/Herdecke, Herdecke, Germany.
Witten/Herdecke University · DEImpact · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDivergent attitudes towards fever have led to a high level of inconsistency in approaches to its management. In an attempt to overcome this, clinical practice guidelines (CPGs) for the symptomatic management of fever in children have been produced by several healthcare organizations. To date, a comprehensive assessment of the evidence level of the recommendations made in these CPGs has not been carried out.

methodsSearches were conducted on Pubmed, google scholar, pediatric society websites and guideline databases to locate CPGs from each country (with date coverage from January 1995 to September 2020). Rather than assessing overall guideline quality, the level of evidence for each recommendation was evaluated according to criteria of the Oxford Centre for Evidence-Based Medicine (OCEBM). A GRADE assessment was undertaken to assess the body of evidence related to a single question: the threshold for initiating antipyresis. Methods and results are reported according to the PRISMA statement.

results74 guidelines were retrieved. Recommendations for antipyretic threshold, type and dose; ambient temperature; dress/covering; activity; fluids; nutrition; proctoclysis; external applications; complementary/herbal recommendations; media; and age-related treatment differences all varied widely. OCEBM evidence levels for most recommendations were low (Level 3-4) or indeterminable. The GRADE assessment revealed a very low level of evidence for a threshold for antipyresis.

conclusionThere is no recommendation on which all guidelines agree, and many are inconsistent with the evidence-this is true even for recent guidelines. The threshold question is of fundamental importance and has not yet been answered. Guidelines for the most frequent intervention (antipyresis) remain problematic.

Indexed as

FeverPractice Guidelines as TopicAntipyreticsChildChild, PreschoolEvidence-Based MedicineHumansAntipyretics

Identifiers

PMID34138848
PMCPMC8211223
OpenAlexW3167928622

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.