Chunming Ma1, Rui Wang1, Yue Liu1, Qiang Lu1, Na Lu1, Yiming Tian1, Xiaoli Liu1, Fuzai Yin2. 1. Department of Endocrinology, First Hospital of Qinhuangdao, Qinhuangdao, China. 2. Department of Endocrinology, First Hospital of Qinhuangdao, Qinhuangdao, China yinfuzai62@163.com.
Abstract
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.
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.