ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2022
Accuracy of the NICE traffic light system in children presenting to general practice: a retrospective cohort study.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed.
- Digital healthcare interventions to support parents with acutely ill children at home: A systematic review.PLOS digital health · 2025Article
- Safety netting advice for acutely ill children presenting to ambulatory care: exploring parents' opinions, ideas, and expectations through focus group interviews.BMC primary care · 2025Article
- Aspects of triage for infants: a narrative review.European journal of pediatrics · 2025Review
- Acutely ill children, safety netting, and NHS printers.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Safety netting in primary care: managing the low incidence, high uncertainty of severe illness.The British journal of general practice : the journal of the Royal College of General Practitioners · 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
- Not too sick, not too well: reducing the diagnostic void in pediatric emergency medicine.Pediatric research · 2024Article
- Management and documentation of pneumonia - a comparison of patients consulting primary care and emergency care.Scandinavian journal of primary health care · 2024Article
- People, humility, and ambition: our vision for the future of general practice.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023Article
- Identifying serious bacterial illness in children: is it time to show the red card to NICE's red flags?The British journal of general practice : the journal of the Royal College of General Practitioners · 2023Article
- NICE guidelines traffic light system in children in general practice.The British journal of general practice : the journal of the Royal College of General Practitioners · 2022Article
- Seeing Red With the NICE Traffic Lights.The British journal of general practice : the journal of the Royal College of General Practitioners · 2022Article
Corrections and comments
- Commented on by
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe National Institute for Health and Care Excellence (NICE) traffic light system was created to facilitate the assessment of unwell children in primary care. To the authors' knowledge, no studies have validated this tool in UK general practice.
aimTo evaluate the accuracy of this system for detecting serious illness in children presenting to general practice. DESIGN AND
settingA retrospective diagnostic accuracy study was undertaken, using a cohort of acutely unwell children aged <5 years presenting to general practice in England and Wales.
methodThe traffic light categories of 6703 children were linked with hospital data to identify admissions and diagnoses. The sensitivity and specificity of these categories were calculated against the reference standard: a hospital-diagnosed serious illness within 7 days of GP consultation, measured using
resultsIn total, 2116 (31.6%) children were categorised as 'red'; 4204 (62.7%) as 'amber'; and 383 (5.7%) as 'green'. There were 139 (2.1%) children who were admitted to hospital within 7 days of consultation, of whom 17 (12.2%; 0.3% overall) had a serious illness. The sensitivity of the red category (versus amber and green) was 58.8% (95% confidence interval [CI] = 32.9 to 81.6) and the specificity 68.5% (95% CI = 67.4 to 69.6). The sensitivity and specificity of red and amber combined (versus green) was 100% (95% CI = 80.5 to 100) and 5.7% (95% CI = 5.2 to 6.3), respectively.
conclusionThe NICE traffic light system did not accurately detect children admitted with a serious illness, nor those not seriously ill who could have been managed at home. This system is not suitable for use as a clinical tool in general practice. Further research is required to update or replace the system.
Indexed as
Identifiers
What 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.