Evidence map›Paper›PMID 39117411›Full record

SynthesisBMJ open2024

Diagnostic prediction models for bacterial meningitis in children with a suspected central nervous system infection: a systematic review and prospective validation study.

Nina S Groeneveld, Merijn W Bijlsma, Ingeborg E van Zeggeren, Steven L Staal, Michael W T Tanck, Diederik van de Beek, Matthijs C Brouwer

Abstract readSystematic Review
In one paragraph

Synthesis in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Observational
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

7 authors.

Nina S GroeneveldDepartment of Neurology, Amsterdam UMC Location AMC, Amsterdam, The Netherlands.ORCID 0000-0002-3519-4015
Merijn W BijlsmaDepartment of Pediatrics, Amsterdam UMC Location AMC, Amsterdam, The Netherlands.
Ingeborg E van ZeggerenDepartment of Neurology, Amsterdam UMC Location AMC, Amsterdam, The Netherlands.
Steven L StaalDepartment of Neurology, Amsterdam UMC Location AMC, Amsterdam, The Netherlands.
Michael W T TanckDepartment of Epidemiology and Data Science, Amsterdam UMC-Locatie AMC, Amsterdam, The Netherlands.ORCID 0000-0001-9828-4459
Diederik van de BeekDepartment of Neurology, Amsterdam UMC Location AMC, Amsterdam, The Netherlands.
Matthijs C BrouwerDepartment of Neurology, Amsterdam UMC Location AMC, Amsterdam, The Netherlands m.c.brouwer@amsterdamumc.nl.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesDiagnostic prediction models exist to assess the probability of bacterial meningitis (BM) in paediatric patients with suspected meningitis. To evaluate the diagnostic accuracy of these models in a broad population of children suspected of a central nervous system (CNS) infection, we performed external validation.

methodsWe performed a systematic literature review in Medline to identify articles on the development, refinement or validation of a prediction model for BM, and validated these models in a prospective cohort of children aged 0-18 years old suspected of a CNS infection. PRIMARY AND SECONDARY OUTCOME MEASURES: We calculated sensitivity, specificity, predictive values, the area under the receiver operating characteristic curve (AUC) and evaluated calibration of the models for diagnosis of BM.

resultsIn total, 23 prediction models were validated in a cohort of 450 patients suspected of a CNS infection included between 2012 and 2015. In 75 patients (17%), the final diagnosis was a CNS infection including 30 with BM (7%). AUCs ranged from 0.69 to 0.94 (median 0.83, interquartile range [IQR] 0.79-0.87) overall, from 0.74 to 0.96 (median 0.89, IQR 0.82-0.92) in children aged ≥28 days and from 0.58 to 0.91 (median 0.79, IQR 0.75-0.82) in neonates.

conclusionsPrediction models show good to excellent test characteristics for excluding BM in children and can be of help in the diagnostic workup of paediatric patients with a suspected CNS infection, but cannot replace a thorough history, physical examination and ancillary testing.

Indexed as

Central Nervous System InfectionsMeningitis, BacterialModels, BiologicalAdolescentArea Under CurveChildChild, PreschoolDiagnosis, DifferentialHumansInfantInfant, NewbornPredictive Value of TestsProspective StudiesROC CurveValidation Studies as Topicdecision makingdiagnostic microbiologyinfectious diseasesneurology

Identifiers

PMID39117411
PMCPMC11404199

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Registered trials

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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.