Summary of findings 5. Paediatric participants ‐ platelet count‐to‐spleen length ratio.
| What is the diagnostic accuracy of platelet count‐to‐spleen length ratio? | ||||||
| Review question | What is the diagnostic accuracy of platelet count‐to‐spleen length ratio 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‐to‐spleen length ratio | |||||
| Reference standards | Upper endoscopy | |||||
| Target condition | Summary accuracy (95% CI) | No. of participants (studies) | Prevalences | Implications in a hypothetical cohort of 1000 people | Post‐test probability | Quality and comments |
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Any varices Cut‐off value: around 1000 (n/mm3)/mm |
Sensitivity 0.74 (0.65 to 0.81) Specificity 0.64 (0.36 to 0.85) LR+ 2.0 (1.0 to 4.0) LR‐ 0.41 (0.27 to 0.61) |
197 participants (2) | 72% and 73% | With a prevalence of 50%, 500 out of 1000 children will have varices of any size. Of these 500 children, 130 (26% of 500) children with varices will receive misdiagnosis and will not receive appropriate prophylaxis or follow‐up The remaining 500 children will have no varices. 180 children (36% of 500) will receive false diagnosis of varices and will undergo an unnecessary endoscopy |
Assuming a pretest probability of 50% Post‐test probabilities:
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Limited evidence. Only 2 studies were found. These 2 studies were at high risk of bias |