Letters “Traffic light” clinical decision tool

Inclusion of urine analysis not justified

BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f2331 (Published 10 July 2013) Cite this as: BMJ 2013;347:f2331
  1. Jiri Chard, senior research fellow1,
  2. Martin Richardson, clinical co-director1,
  3. Stephen Murphy, consultant paediatrician2
  4. On behalf of the Guideline Development Group and technical team
  1. 1National Collaborating Centre for Women’s and Children’s Health, London W1T 2QA, UK
  2. 2Peterborough and Stamford Hospitals Foundation Trust, Peterborough, UK
  1. jchard{at}ncc-wch.org.uk

De and colleagues’ study goes some way towards validating the National Institute for Health and Care Excellence “traffic light” system on feverish illness in children,1 2 the implementation of which has been questioned.3

The study showed that the “traffic light” system had a sensitivity of 85.8% and a specificity of 28.5% in detecting urinary tract infection, pneumonia, or bacteraemia in young children in amber or red categories. Limitations of the study aside, we believe these results show that the system is a valuable screening tool for assessing the risk of serious illness in young children with fever.

De and colleagues suggest that because …

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