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Q In children, what is the accuracy of signs, symptoms, and laboratory tests for detecting dehydration?
Clinical impact ratings GP/FP/Primary care ★★★★★★☆ GP/FP/Emergency Medicine ★★★★★★☆ Emergency Medicine (Specialist) ★★★★★★☆ Paediatrics ★★★★★★☆
Medline (January 1966 to April 2003), the Cochrane Library, reference lists, and experts in the field.
Study selection and assessment:
studies in any language that compared signs, symptoms, and laboratory values with a recognised gold standard for diagnosing dehydration in children (age 0–18 y). Study quality was ranked from highest quality (level 1 = independent, blind comparisons of test with a valid gold standard) to lowest quality (level 5 = non-independent comparison of test with an uncertain standard of validity, which may incorporate the test result into the gold standard).
sensitivity, specificity, and positive and negative likelihood ratios (LRs).
13 studies (n = 1246) met the selection criteria (4 intermediate quality and 9 low quality). Clinically useful signs for detecting 5% dehydration were capillary refill time, abnormal skin turgor, and abnormal respiratory pattern (table). …
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