Diagnostic accuracy of point-of-care devices for detection of anemia in children in community settings: a systematic review and meta-analysis.

Introduction: A number of clinical studies have been conducted comparing the diagnostic accuracy of non-invasive and invasive point-of-care diagnostic tests for anemia, using reference standards such as hematology autoanalyzers.

Methods: This meta-analysis was performed to determine the pooled estimate for the diagnostic accuracy of point-of-care devices for the detection of anemia in community settings in children aged up to 14 years and determining whether the diagnostic accuracy of various point-of-care devices differs significantly. We included only original clinical studies with a sample size of 25 or more in the review. The QUADAS-2 tool was employed to evaluate the risk of bias and concerns regarding the applicability of the included studies.

Results: A total of 16 studies (HemoCue in 11; WHO Hemoglobin Color Scale in 3; Masimo, AnemoCheck-LRS, and Sahli's hemoglobinometer in 1 study each) were included. The pooled estimates for the sensitivity and specificity of point-of-care tests were 79.5% (95% CI: 65.6-88.7%) and 90.1% (95% CI: 82.5-94.6%), respectively. The difference in the level of hemoglobin measured was also insignificant between point-of-care and reference standards (MD: 0.2 [95% CI: - 0.2 to 0.6], p = 0.33), as well as for HemoCue and WHO Hemoglobin Color Scale subgroups (p = 0.73 and 0.05, respectively). The sensitivity and specificity of HemoCue and WHO Hemoglobin Color Scale were 79% (95% CI: 78-80%)/93% (95% CI: 92-94%) and 89% (95% CI: 86-91%)/88% (95% CI: 74-95%), respectively.

Conclusions: Point-of-care diagnostic tests for anemia have acceptable sensitivity and specificity for screening anemia in children. There was no significant difference between the performance of HemoCue and the WHO Hemoglobin Color Scale. Prospero registration number: CRD42023386952 What is known? • Anemia is a major health prob lem in children in many countries across the world. • Screening for anemia in the community is important for timely therapeutic intervention. • Point-of-care testing (POCT) devices for anemia in children allow for quick Hb assessments at the site of care, providing immediate results. • Both non-invasive and micro-invasive POCT devices for anemia are currently available. What is new? • Point-of-care diagnostic tests for anemia have acceptable sensitivity and specificity for screening anemia in children. • There is no significant difference between the performance of HemoCue and the WHO Hemoglobin Color Scale.