Key result
Screening tools including the BP-to-height ratio and age-based tables identified elevated blood pressure in children with high sensitivities (97-98%) and moderate specificities (71-89%).
Why the study?
Do user-friendly screening tools accurately identify elevated blood pressure in children aged 3 to 18 years compared to standard age-, sex-, and height-specific BP percentiles?
Meta-Analysis (n=366,321)
Do user-friendly screening tools accurately identify elevated blood pressure in children aged 3 to 18 years compared to standard age-, sex-, and height-specific BP percentiles?
Effect estimate: sensitivities 97-98%, specificities 71-89%
Simplified screening tools like the BP-to-height ratio demonstrate high sensitivity for detecting elevated blood pressure in children, offering a practical approach to improve pediatric hypertension screening.
Variable accuracy of pediatric BP screening tools; leaves open optimal method for clinical use.
CONTEXT: Hypertension is frequently undiagnosed in children. Several methods have been developed to simplify screening for elevated blood pressure (BP) in children. OBJECTIVE: to assess the performance of different screening tools in identifying elevated BP in the pediatric population. DATA SOURCES: Data sources such as PubMed, Embase, Web of Science, Cochrane, and Scopus were searched up to March 2016. STUDY SELECTION: Studies providing measures of diagnostic performance of screening tools and that used age-, sex-, and height-specific BP percentile as the reference standard were included. DATA EXTRACTION: Data regarding the population, screening tools used to define elevated BP, and diagnostic criteria of BP were extracted. Available data on true-positive, false-positive, true-negative, and false-negative results were also extracted to construct a 2 × 2 contingency table. RESULTS: A total of 16 eligible studies that evaluated 366 321 children aged 3 to 18 years were included in the meta-analysis. Nine screening tools were included in this study, in which the BP-to-height ratio, the modified BP-to-height ratio, and tables based on age categories had the highest sensitivities (97-98%) but moderate specificities (71-89%). LIMITATIONS: Limitations included that BP measurements in most studies were based on 1 visit only and there was heterogeneity between the studies. CONCLUSIONS: Several user-friendly screening tools could improve the screening of elevated BP in the pediatric population.
No takes yet. Share an insight, caveat, or question.
Ma et al. (2017) conducted a meta-analysis in Elevated blood pressure (n=366,321). Screening tools for elevated blood pressure vs. Age-, sex-, and height-specific BP percentile was evaluated on Identification of elevated BP (sensitivities 97-98%, specificities 71-89%). Screening tools including the BP-to-height ratio and age-based tables identified elevated blood pressure in children with high sensitivities (97-98%) and moderate specificities (71-89%).