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Should all acutely ill children in primary care be tested with point-of-care CRP: a cluster randomised trial

Overview of attention for article published in BMC Medicine, October 2016
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (97th percentile)

Mentioned by

news
11 news outlets
blogs
2 blogs
twitter
12 tweeters
facebook
1 Facebook page

Citations

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27 Dimensions

Readers on

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90 Mendeley
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Title
Should all acutely ill children in primary care be tested with point-of-care CRP: a cluster randomised trial
Published in
BMC Medicine, October 2016
DOI 10.1186/s12916-016-0679-2
Pubmed ID
Authors

Jan Y. Verbakel, Marieke B. Lemiengre, Tine De Burghgraeve, An De Sutter, Bert Aertgeerts, Bethany Shinkins, Rafael Perera, David Mant, Ann Van den Bruel, Frank Buntinx

Abstract

Point-of-care blood C-reactive protein (CRP) testing has diagnostic value in helping clinicians rule out the possibility of serious infection. We investigated whether it should be offered to all acutely ill children in primary care or restricted to those identified as at risk on clinical assessment. Cluster randomised controlled trial involving acutely ill children presenting to 133 general practitioners (GPs) at 78 GP practices in Belgium. Practices were randomised to undertake point-of-care CRP testing in all children (1730 episodes) or restricted to children identified as at clinical risk (1417 episodes). Clinical risk was assessed by a validated clinical decision rule (presence of one of breathlessness, temperature ≥ 40 °C, diarrhoea and age 12-30 months, or clinician concern). The main trial outcome was hospital admission with serious infection within 5 days. No specific guidance was given to GPs on interpreting CRP levels but diagnostic performance is reported at 5, 20, 80 and 200 mg/L. Restricting CRP testing to those identified as at clinical risk substantially reduced the number of children tested by 79.9 % (95 % CI, 77.8-82.0 %). There was no significant difference between arms in the number of children with serious infection who were referred to hospital immediately (0.16 % vs. 0.14 %, P = 0.88). Only one child with a CRP < 5 mg/L had an illness requiring admission (a child with viral gastroenteritis admitted for rehydration). However, of the 80 children referred to hospital to rule out serious infection, 24 (30.7 %, 95 % CI, 19.6-45.6 %) had a CRP < 5 mg/L. CRP testing should be restricted to children at higher risk after clinical assessment. A CRP < 5 mg/L rules out serious infection and could be used by GPs to avoid unnecessary hospital referrals. ClinicalTrials.gov Identifier: NCT02024282 (registered on 14(th) September 2012).

Twitter Demographics

The data shown below were collected from the profiles of 12 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 90 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 1%
Germany 1 1%
Unknown 88 98%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 19 21%
Student > Master 16 18%
Researcher 12 13%
Other 9 10%
Student > Ph. D. Student 7 8%
Other 16 18%
Unknown 11 12%
Readers by discipline Count As %
Medicine and Dentistry 49 54%
Biochemistry, Genetics and Molecular Biology 7 8%
Nursing and Health Professions 5 6%
Engineering 3 3%
Psychology 2 2%
Other 12 13%
Unknown 12 13%

Attention Score in Context

This research output has an Altmetric Attention Score of 105. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 25 May 2017.
All research outputs
#272,565
of 19,872,770 outputs
Outputs from BMC Medicine
#222
of 2,931 outputs
Outputs of similar age
#6,949
of 288,846 outputs
Outputs of similar age from BMC Medicine
#1
of 1 outputs
Altmetric has tracked 19,872,770 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 98th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,931 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 39.4. This one has done particularly well, scoring higher than 92% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 288,846 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 97% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them