Results
The present meta-analysis included 13 studies out of 1051 studies based
on the accuracy of PECARN, as shown in Figure 1. Among 13 articles,
eight articles have categorized the patient sample as <2 years
and ≥ 2 years of age, and five studies included patients as 0-18 years
of age. A total sample size of 70,362 patients was included for the
analysis from all the studies. Table 1 shows Demographic characteristics
of included studies summarizing the author, time, place of study, study
design, the severity of the injury, mean age, gender, practitioner
assessing the patient, total sample size, and sample size depending on
the age group.
For patients below two years of age, sensitivity analysis showed a
pooled sensitivity of 0.08 (95% confidence interval [CI] of 0.074 -
0.087) with an inconsistency of 99.6%, which was significant at
p<0.05 (Figure 2). Pooled specificity of 0.20 ( 95% CI of
0.196 - 0.213), which was significant at p <0.05 (Figure 3).
The positive likelihood ratio was 0.17 (95% CI of 0.030 - 0.989), the
negative likelihood ratio was 45.59 (95% CI 0.000 -0.166), and
diagnostic odds ratio was 0.004 (95% CI of 0.000-0.1666) with a
statistically significant value of p<0.05. ROC curve obtained
showed the inclination of the curve towards the lower right depicting
good diagnostic accuracy (Figure 4)
For patients equal to or above two years of age, sensitivity analysis
showed a pooled sensitivity of 0.07 with an inconsistency of 99.5%,
which was statistically significant (p<0.05) (Figure 5).
Pooled specificity of 0.66 with the inconsistency of 99.9%, which was
significant at p<0.05, was shown in Figure 6. The positive
likelihood ratio was 1.46 (95% CI of 0.067 - 31.62), the negative
likelihood ratio was 1.21 (95% CI 0.95 -1.54), and the diagnostic odd
ratio was 0.54 (95% CI of 0.10 -2.78) with a statistically significant
value of p<0.05. ROC curve obtained showed the inclination of
the curve towards the lower left (Figure 7).
For the age group of 0-18years, sensitivity analysis showed a pooled
sensitivity of 0.13 (95% CI 0.12-0.14) with an inconsistency of 86.7%,
which was significant at p<0.05 (Figure 8). Pooled specificity
of 0.81 (95% CI 0.80-0.82) with the inconsistency of 99.7%,
significant at p<0.05, was shown in Figure 9. The positive
likelihood ratio was 1.05 (95% CI of 0.25 – 4.34), the negative
likelihood ratio was 1.36 (95% CI 1.05 -1.76), and the diagnostic odd
ratio was 0.79 (95% CI of 0.08 -7.71) with a statistically significant
value of p<0.05. ROC curve obtained showed the inclination of
the curve towards the lower left (Figure 10).