Table 1

 Reviews of inflammatory markers for diagnosis of specific conditions

Target condition (test)SettingStudy typeOutcome
Chorioamnionitis in premature delivery (CRP)Secondary careSystematic review (6 reports; 466 patients)8Summary sensitivity 73%, specificity 76%
Serious infections in febrile children (CRP, ESR)Secondary careSystematic reviews (5/6 reports on CRP/ESR; 1379 patients having CRP)9 10Likelihood ratio of raised CRP 3.2 (95% CI 2.7 to 3.7); negative likelihood ratio 0.33 (0.23 to 0.49).10 Similar results in second review9
Bacterial chest infection in children (CRP)Secondary careSystematic review (8 reports; 1230 patients)11 Pooled odds ratio for raised CRP and bacterial infection 2.6 (1.2 to 5.6)
Bacterial chest infection in adults (CRP)Primary care; accident and emergency departmentsSystematic review (8 reports, with 2194 patients)12 Likelihood ratio of raised CRP 2.1 (95% CI 1.8 to 2.4); negative likelihood ratio 0.33 (0.25 to 0.43). Similar results in an earlier review13 and a subsequent study in primary care14
Appendicitis in children with abdominal pain (CRP, ESR) Secondary care (mainly emergency departments)Systematic review of all features of appendicitis, including 5 studies of CRP, 1 of ESR; 730 and 162 children repsectivley15Likelihood ratio of raised CRP increases as CRP increases: 5.2 (1.7 to 16) for CRP >25 mg/L. For normal CRP, 0.44 to 0.47. For ESR >20 mm/h, 3.8 (1.8 to 8.1)
Osteomyelitis of the leg in diabetes (ESR) Secondary care (inpatients and outpatients)Systematic review of all features of osteomyelitis, including 3 studies of ESR; 92 patients16Summary likelihood ratio of ESR >70 mm/h 11 (1.6 to 79).
Infection in revision hip arthroplasties (CRP, ESR) Secondary careCohort study of 178 patients; 202 arthroplasties 17ESR >30 mm/h: sensitivity 0.82 (0.65 to 0.93), specificity 0.85 (0.78 to 0.91); CRP >100 mg/L 0.96 (0.78 to 1.0), 0.92 (0.85 to 0.96). No patient with an infected arthroplasty had negative result on both tests

CRP=C reactive protein; ESR= erythrocyte sedimentation rate. 95% CI= 95% confidence interval.