Pediatric anesthesia & critical care
Ancillary investigations for death determination in infants and children: a systematic review and meta-analysis
Authors' conclusion
The ancillary investigation for DNC in infants and children with the greatest accuracy appears to be radionuclide scintigraphy using HMPAO with or without tomographic imaging; however, the certainty of the evidence is low.
Study context
- Population
- Infants and children undergoing declaration of death by neurologic criteria39 manuscripts
- Participants
- 866 infants
- Comparison
- 18 ancillary investigations for death by neurologic criteria
- Outcome
- Diagnostic accuracy of ancillary investigations
Methodological detailsfixed-effects model, QUADAS-2 risk of bias, GRADE certainty of evidence
- Fixed-effects model
- QUADAS-2 risk of bias
- GRADE certainty of evidence
Pooled result
As reported in the abstract
| Group | Sensitivity | Specificity |
|---|---|---|
| Radionuclide scintigraphy (HMPAO) | 0.99 (95% HDI, 0.89 to 1.00) | 0.97 (95% HDI, 0.65 to 1.00) |
Radionuclide scintigraphy (HMPAO)
Sensitivity0.99 (95% HDI, 0.89 to 1.00)
Specificity0.97 (95% HDI, 0.65 to 1.00)
- Sensitivity range across ancillary investigations
- 0.00 to 1.00
- Specificity range across ancillary investigations
- 0.50 to 1.00
Further pooled results
Certainty of evidence (GRADE)
- Low to very low for all ancillary investigations, except moderate for radionuclide dynamic flow studies
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Ancillary investigations for death determination in infants and children: a systematic review and meta-analysis. Can J Anaesth. Published 2 May 2023. doi:10.
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