Diagnosing Clinically Significant Dehydration in XXXX with Acute Gastroenteritis Using Noninvasive Methods: A Meta-Analysis.

@entity1 @entity922 @entity2700 @entity1902
OBJECTIVE: To determine the most accurate, noninvasive method of assessing @entity2700 . STUDY DESIGN: The following data sources were searched: electronic databases, gray literature, scientific meetings, reference lists, and authors of unpublished studies. Eligible studies were comparative outpatient evaluations that used an accepted reference standard and were conducted in developed countries in @entity1 aged <18  years with @entity1902 . Data extraction was completed independently by multiple reviewers before a consensus was made. RESULTS: Nine studies that included 1039 @entity1 were identified. The 4-item @entity922 ( @entity922 ), the "Gorelick" score, and unstructured physician assessment were evaluated in 3, 2, and 5 studies, respectively. Bedside ultrasound, capillary digital videography, and urinary measurements were each evaluated in one study. The @entity922 had a positive likelihood ratio (LR) range of 1.87-11.79 and a negative LR range of 0.30-0.71 to predict 6% @entity2700 . When combined with the 4-item Gorelick Score, the positive LR was 1.93 (95% CI 1.07-3.49) and negative LR was of 0.40 (95% CI 0.24-0.68). Unstructured @entity2700 assessment had a pooled positive LR of 2.13 (95% CI 1.33-3.44) and negative LR of 0.48 (95% CI 0.28-0.82) to detect >= 5% @entity2700 . CONCLUSIONS: Overall, the clinical scales evaluated provide some improved diagnostic accuracy. However, test characteristics indicate that their ability to identify @entity1 both with and without @entity2700 is suboptimal. Current evidence does not support the routine use of ultrasound or urinalysis to determine @entity2700 severity.
