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A meta-analysis of the reliability of the history in suspected poisoning
1Mater Dei Hospital, Msida, Malta.
Background:
Management of acute poisoning depends on the reliability of history of the poisoning event.
Objective:
The objective of this study was to perform a meta-analysis from published data to determine summary measures of reliability of history in suspected acute poisoning.
Method:
Relevant studies were selected from a search on the Medline database to perform a meta-analysis to calculate pooled estimates of κ statistic for agreement between history of poisoning and laboratory diagnosis.
Results:
A total of seven articles were included in the meta-analysis. The κ statistic varied from 0.35 (95% confidence interval [CI] 0.135-0.558) for 3,4-methylenedioxy-N-methylamphetamine (MDMA, also known as ecstasy) to 0.69 (95% CI 0.648-0.733) for paracetamol.
Conclusions:
A history of paracetamol ingestion is moderately reliable, and further evaluation is required to make a clinical diagnosis of acute poisoning with street drugs.
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