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. 2017 Apr 26;2017(4):CD008759. doi: 10.1002/14651858.CD008759.pub2

Summary of findings 4. Paediatric participants ‐ platelet count.

What is the diagnostic accuracy of platelet count?
 
Review question What is the diagnostic accuracy of platelet count for the diagnosis of oesophageal varices in paediatric people with liver disease or portal vein thrombosis?
Population Children with diagnosis of chronic liver disease or portal vein thrombosis. Age < 18 years
Settings Outpatients and inpatients in secondary/tertiary care setting
Study design Prospective and retrospective cross‐sectional studies. No case‐control studies were found
Index tests Platelet count
Reference standards Upper endoscopy
             
Target condition Summary accuracy(95% CI) No. of participants (studies) Prevalence,
Median
(range )
Implications in a hypothetical cohort of 1000 people Post‐test probability Quality and comments
             
Any varices
Cut‐off value: around 120,000 /mm3 (range 115,000 to 119,000/mm3)
Sensitivity 0.71 (0.60 to 0.80)
Specificity 0.83 (0.70 to 0.91)
LR+ 4.2
 (2.4 to 7.3)
LR‐ 0.35
 (0.25 to 0.48)
277 participants (4) 58%
 (48% to 69%) With a prevalence of 58%, 580 out of 1000 children will have varices of any size. Of these 580 children, 168 (29% of 580) children with varices will receive misdiagnosis and will not receive appropriate. prophylaxis or follow‐up
The remaining 420 children will have no varices. 71 children (17% of 420) will receive false diagnosis of varices and will undergo an unnecessary endoscopy
Assuming a pretest probability of 58%
Post‐test probabilities:
  • If test positive: 85%

  • If test negative: 32.5%

Studies were at high risk of bias