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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