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Impact of C-reactive protein test results on evidence-based decision-making in cases of bacterial infection

Show simple item record Nabulsi M. Hani A. Karam M.
dc.contributor.editor Sep-2012 2017-10-05T16:01:17Z 2017-10-05T16:01:17Z 2012
dc.identifier 10.1186/1471-2431-12-140
dc.identifier.issn 14712431
dc.description.abstract Background: C-reactive protein (CRP) is widely used to detect bacterial infection in children. We investigated the impact of CRP test results on decision-making and summarized the evidence base (EB) of CRP testing.Methods: We collected information from the hospital records of 91 neonates with suspected sepsis and of 152 febrile children with suspected infection on the number of ordered CRP tests, the number of EB-CRP tests, and the impact of the test results on decision-making. CRP diagnostic accuracy studies focusing on pediatric infections were reviewed critically. The main outcomes were the proportion of CRP tests that were EB and the proportion of tests that affected decision-making. A secondary outcome was the overall one-year expenditure on CRP testing.Results: The current EB for CRP testing in pediatric infections is weak and suggests that CRP is of low diagnostic value. Approximately 54.8percent of tests performed for suspected neonatal sepsis and 28percent of tests performed for other infections were EB; however, the results of only 12.9percent of neonatal sepsis tests and of 29.9percent of tests on children with other infections informed decision-making. The one-year overall cost for CRP testing and related health care was $26,715.9.Conclusions: The routine ordering of CRP for children with infections is based on weak evidence. The impact of the CRP test results on decision-making is rather small, and CRP ordering may contribute to unnecessary health care expenditures. Better quality research is needed to definitively determine the diagnostic accuracy of CRP levels in children with infections. © 2012 Nabulsi et al.; licensee BioMed Central Ltd.
dc.language English
dc.publisher LONDON
dc.relation.ispartof Publication Name: BMC Pediatrics; Publication Year: 2012; Volume: 12;
dc.source Scopus
dc.title Impact of C-reactive protein test results on evidence-based decision-making in cases of bacterial infection
dc.type Article
dc.contributor.affiliation Nabulsi, M., Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, P.O. Box: 113-6044-C8, Beirut, Lebanon
dc.contributor.affiliation Hani, A., Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, P.O. Box: 113-6044-C8, Beirut, Lebanon
dc.contributor.affiliation Karam, M., Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, P.O. Box: 113-6044-C8, Beirut, Lebanon
dc.contributor.authorAddress Nabulsi, M.; Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, P.O. Box: 113-6044-C8, Beirut, Lebanon; email:
dc.contributor.authorCorporate University: American University of Beirut Medical Center; Faculty: Faculty of Medicine; Department: Pediatrics and Adolescent Medicine;
dc.contributor.authorDepartment Pediatrics and Adolescent Medicine
dc.contributor.faculty Faculty of Medicine
dc.contributor.authorInitials Nabulsi, M
dc.contributor.authorInitials Hani, A
dc.contributor.authorInitials Karam, M
dc.contributor.authorReprintAddress Nabulsi, M (reprint author), Amer Univ Beirut, Med Ctr, Dept Pediat and Adolescent Med, POB 113-6044-C8, Beirut, Lebanon.
dc.contributor.authorUniversity American University of Beirut Medical Center
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dc.description.citedTotWOSCount 1
dc.description.citedWOSCount 0
dc.format.extentCount 1
dc.identifier.articleNo 140
dc.identifier.coden BPMEB
dc.identifier.pubmedID 22943554
dc.identifier.scopusID 84865588844
dc.publisher.address 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND
dc.relation.ispartOfISOAbbr BMC Pediatr.
dc.relation.ispartofPubTitle BMC Pediatrics
dc.relation.ispartofPubTitleAbbr BMC Pediatr.
dc.relation.ispartOfVolume 12
dc.source.ID WOS:000309111700001
dc.type.publication Journal
dc.subject.otherAuthKeyword Bacterial infection
dc.subject.otherAuthKeyword C-reactive protein
dc.subject.otherAuthKeyword Diagnostic accuracy
dc.subject.otherAuthKeyword Neonatal sepsis
dc.subject.otherChemCAS C reactive protein, 9007-41-4
dc.subject.otherChemCAS Biological Markers
dc.subject.otherChemCAS C-Reactive Protein, 9007-41-4
dc.subject.otherIndex antibiotic agent
dc.subject.otherIndex C reactive protein
dc.subject.otherIndex acute appendicitis
dc.subject.otherIndex acute gastroenteritis
dc.subject.otherIndex acute otitis media
dc.subject.otherIndex acute sinusitis
dc.subject.otherIndex article
dc.subject.otherIndex bacterial infection
dc.subject.otherIndex bone and joint infections
dc.subject.otherIndex cellulitis
dc.subject.otherIndex clinical decision making
dc.subject.otherIndex diagnostic accuracy
dc.subject.otherIndex diagnostic value
dc.subject.otherIndex evidence based practice
dc.subject.otherIndex female
dc.subject.otherIndex fever
dc.subject.otherIndex health care
dc.subject.otherIndex health care cost
dc.subject.otherIndex hospital admission
dc.subject.otherIndex hospitalization
dc.subject.otherIndex human
dc.subject.otherIndex major clinical study
dc.subject.otherIndex male
dc.subject.otherIndex medical record
dc.subject.otherIndex meningitis
dc.subject.otherIndex newborn
dc.subject.otherIndex newborn sepsis
dc.subject.otherIndex osteomyelitis
dc.subject.otherIndex pneumonia
dc.subject.otherIndex soft tissue infection
dc.subject.otherIndex tonsillitis
dc.subject.otherIndex Adolescent
dc.subject.otherIndex Bacterial Infections
dc.subject.otherIndex Biological Markers
dc.subject.otherIndex C-Reactive Protein
dc.subject.otherIndex Child
dc.subject.otherIndex Child, Preschool
dc.subject.otherIndex Decision Support Techniques
dc.subject.otherIndex Evidence-Based Medicine
dc.subject.otherIndex Female
dc.subject.otherIndex Health Expenditures
dc.subject.otherIndex Hospitals, University
dc.subject.otherIndex Humans
dc.subject.otherIndex Infant
dc.subject.otherIndex Infant, Newborn
dc.subject.otherIndex Lebanon
dc.subject.otherIndex Male
dc.subject.otherIndex Physician's Practice Patterns
dc.subject.otherIndex Retrospective Studies
dc.subject.otherIndex Sepsis
dc.subject.otherKeywordPlus BLOOD-CELL COUNT
dc.subject.otherKeywordPlus URINARY-TRACT-INFECTION
dc.subject.otherKeywordPlus ACUTE PYELONEPHRITIS
dc.subject.otherKeywordPlus SERUM PROCALCITONIN
dc.subject.otherKeywordPlus SEPTIC ARTHRITIS
dc.subject.otherKeywordPlus NEONATAL SEPSIS
dc.subject.otherKeywordPlus OTITIS-MEDIA
dc.subject.otherKeywordPlus CHILDREN
dc.subject.otherWOS Pediatrics

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