Evidence map›Paper›PMID 36333682›Full record

Observational studyBMC pediatrics2022

Point-of-care C-reactive protein test results in acute infections in children in primary care: an observational study.

Liselore De Rop, Tine De Burghgraeve, An De Sutter, Frank Buntinx, Jan Y Verbakel

Registry-linked trialOpen access · goldAbstract readObservational Study
In one paragraph

Observational study in BMC pediatrics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02024282 (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."), which is not on this map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.8field-weighted citation impact, top 15% 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.

NCT02024282 nacompletednot on this map

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."

TypeinterventionalSponsorKU LeuvenRan2013 to 2014Enrolled8,962ConditionsSepsis, Bacteraemia, Meningitis, AbscessArmsUse of C-reactive protein (CRP) point of care test, Brief intervention and parent leaflet, Finger Pulse Oximeter
3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 9 citations in OpenAlex.

  1. Trial
  2. Observational
  3. Article
  4. Article
  5. Article
  6. 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

5 authors at 2 institutions in 3 countries.

Liselore De RopEPI-Centre, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium. liselore.derop@kuleuven.be.
Tine De BurghgraeveEPI-Centre, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
An De SutterDepartment of Family Practice and Primary Health Care, Ghent University, Ghent, Belgium.
Frank BuntinxEPI-Centre, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
Jan Y VerbakelEPI-Centre, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
KU Leuven · BEGhent University · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute infections are a common reason for children to consult primary care. Serious infections are rare but differentiating them from self-limiting illnesses remains challenging. This can lead to inappropriate antibiotic prescribing. Point-of-care C-reactive protein testing is used to guide antibiotic prescribing in adults. However, in children its use remains unclear. The purpose of this study was to assess point-of-care CRP test levels with respect to patients' characteristics, care setting, preliminary diagnosis, and management.

methodsA prospective observational study was performed in children with an acute infection presenting to ambulatory care in Belgium.

resultsIn this study 8280 cases were analysed, of which 6552 had a point-of-care CRP value available. A total of 276 physicians participated. The median patient age was 1.98 years (IQR 0.97 to 4.17), 37% of children presented to a general practitioner, 33% to a paediatric out-patient clinic, and 30% to the emergency department. A total of 131 different preliminary diagnoses were found, with acute upper airway infection as the most frequent. In 6% (n = 513) patients were diagnosed with a serious infection. The most common serious infection was pneumonia. Antibiotics were prescribed in 28% (n = 2030) of all episodes. The median CRP over all infectious episodes was 10 mg/L (IQR < 5-29). Children below 5 years of age and those presenting to a paediatrician had a higher median CRP. Median CRP in patients with serious infections was 21 mg/L (IQR 6 to 63.5). Pneumonia had a median CRP of 48 mg/L (IQR 13-113). In the episodes with antibiotics prescription, median CRP level was 29 mg/L (IQR 10-58) compared to 7 mg/L (IQR < 5-19) when they were not prescribed.

conclusionA low POC CRP as a standalone tool did not seem to be sufficient to rule out serious infections, but its potential in assessing serious infections could increase when integrated in a clinical decision rule.

trial registrationClinicalTrials.gov Identifier: NCT02024282 (registered on 31/12/2013).

Indexed as

InfectionsPneumoniaAdultAnti-Bacterial AgentsChildChild, PreschoolC-Reactive ProteinHumansInfantPoint-of-Care SystemsPrimary Health CareAnti-Bacterial AgentsC-Reactive ProteinAcute illnessChildC-reactive proteinPoint-of-care systemsPrimary careSerious infections

Identifiers

PMID36333682
PMCPMC9635070
OpenAlexW4308337198

What OpenQuestion holds

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LicenceCC BY
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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.