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Table 4 Performance of the PECARN, CATCH, CHALICE and SNC guidelines in the comparison cohort with all children presenting within 24 h of injury and GCS 13–15 (n = 18,913)

From: External validation of the Scandinavian guidelines for management of minimal, mild and moderate head injuries in children

  PECARN CATCH CHALICE SNC
  < 2 years 2 years
n = 5046 n = 13,867
Primary outcome
   Positive Negative   Positive Negative   Positive Negative   Positive Negative   Positive Negative
Clinically important traumatic brain injury * Yes 42 0 Yes 117 1 Yes 147 13 Yes 148 12 Yes 156 4
No 2047 2957 No 6606 7143 No 5560 13,193 No 4018 14,735 No 7704 11,049
Sens (95% CI) 42/42 117/118 147/160 148/160 156/160
100∙0% (91∙6–100∙0) 99∙2% (95∙4–100∙0) 91∙9% (86∙5–95∙6) 92∙5% (87∙3–96∙1) 97.5% (93.7–99.3)
Spec (95% CI) 2957/5004 7143/13749 13,193/18753 14,735/18753 11,049/18753
59∙1% (57∙7–60∙5) 52∙0% (51∙1–52∙8) 70∙4% (69∙7–71∙0) 78∙6% (78∙0–79∙2) 58.9% (58.2–59.6)
PPV (95% CI) 42/2089 117/6723 147/5707 148/4166 156/7860
2∙0% (1∙5–2∙7) 1∙7% (1∙4–2∙1) 2∙6% (2∙2–3∙0) 3∙6% (3∙0–4∙2) 2.0% (1.7–2.3)
NPV (95% CI) 2957/2957 7143/7144 13,193/13206 14,735/14747 11,049/11053
100∙0% (99∙9–100∙0) 100∙0% (99∙9–100∙0) 99∙9% (99∙8–99∙9) 99∙9% (99∙9–100∙0) 100% (99∙9–100∙0)
Secondary outcomes
   Positive Negative   Positive Negative   Positive Negative   Positive Negative   Positive Negative
Traumatic brain injury on CT* Yes 70 0 Yes 180 1 Yes 220 31 Yes 227 24 Yes 237 14
No 2019 2957 No 6543 7143 No 5487 13,175 No 3939 14,723 No 7623 11,039
Sens (95% CI) 70/70 180/181 220/251 227/251 237/251
100∙0% (94∙9–100∙0) 99∙4% (97∙0–100∙0) 87∙6% (82∙9–91∙5) 90∙4% (86∙1–93∙8) 94.4% (90.8–96.9)
Spec (95% CI) 2957/4976 7143/13686 13,175/18662 14,723/18662 11,039/18662
59∙4% (58∙0–60∙8) 52∙2% (51∙4–53∙0) 70∙6% (69∙9–71∙3) 78∙9% (78∙3–79∙5) 59.2% (58.4–59.9)
PPV (95% CI) 70/2089 180/6723 220/5707 227/4166 237/7860
3∙4% (2∙6–4∙2) 2∙7% (2∙3–3∙1) 3∙9% (3∙4–4∙4) 5∙4% (4∙8–6∙2) 3.0% (2.6–3.4)
NPV (95% CI) 2957/2957 7143/7144 13,175/13206 14,723/14747 11,039/11053
100∙0% (99∙9–100∙0) 100∙0% (99∙9–100∙0) 99∙8% (99∙7–99∙8) 99∙8% (99∙8–99∙9) 99.9% (99.8–99.9)
   Positive Negative   Positive Negative   Positive Negative   Positive Negative   Positive Negative
Neurosurgery* Yes 6 0 Yes 18 0   Yes 23 1 Yes 22 2 Yes 24 0
No 2083 2957 No 6705 7144 No 5684 13, 205 No 4144 14,745 No 7835 11,052
Sens (95% CI) 6/6 18/18 23/24 22/24 24/24
100∙0% (54∙1–100∙0) 100∙0% (81∙5–100∙0) 95∙8% (78∙9–99∙9) 91∙7% (73∙0–99∙0) 100.0% (85.8–100.0)
Spec (95% CI) 2957/5040 7144/13849 13,205/18889 14,745/18889 11,052/18889
58∙7% (57∙3–60∙0) 51∙6% (50∙7–52∙4) 69∙9% (69∙2–70∙6) 78∙1% (77∙5–78∙6) 58.5% (57.8–59.2)
PPV (95% CI) 6/2089 18/6723 23/5707 22/4166 24/7859
0∙3% (0∙1–0∙6) 0∙3% (0∙2–0∙4) 0∙4% (0∙3–0∙6) 0∙5% (0∙3–0∙8) 0.3% (0.2–0.5)
NPV (95% CI) 2957/2957 7144/7144 13,205/13206 14,745/14747 11,052/11052
100∙0 (99∙9–100∙0) 100∙0% (99∙9–100∙0) 100∙0% (100∙0–100∙0) 100∙0% (100∙0–100∙0) 100∙0% (100∙0–100∙0)
  1. PECARN Paediatric Emergency Care Applied Research Network, CATCH Canadian Assessment of Tomography for Childhood Head Injury, CHALICE Children’s Head Injury Algorithm for the Prediction of Important Clinical Events, Sens sensitivity, Spec specificity, PPV positive predictive value, NPV negative predictive value
  2. aSee text for detailed definitions