title: Performance of User-Friendly Screening Tools for Elevated Blood Pressure in Children.
abstract: BACKGROUND
  Hypertension is frequently undiagnosed in children. Several methods have been developed to simplify screening for elevated blood pressure (BP) in children.
  
  
  OBJECTIVE
  to assess the performance of different screening tools in identifying elevated BP in the pediatric population.
  
  
  METHODS
  Data sources such as PubMed, Embase, Web of Science, Cochrane, and Scopus were searched up to March 2016.
  
  
  METHODS
  Studies providing measures of diagnostic performance of screening tools and that used age-, sex-, and height-specific BP percentile as the reference standard were included.
  
  
  METHODS
  Data regarding the population, screening tools used to define elevated BP, and diagnostic criteria of BP were extracted. Available data on true-positive, false-positive, true-negative, and false-negative results were also extracted to construct a 2 × 2 contingency table.
  
  
  RESULTS
  A total of 16 eligible studies that evaluated 366 321 children aged 3 to 18 years were included in the meta-analysis. Nine screening tools were included in this study, in which the BP-to-height ratio, the modified BP-to-height ratio, and tables based on age categories had the highest sensitivities (97-98%) but moderate specificities (71-89%).
  
  
  CONCLUSIONS
  Limitations included that BP measurements in most studies were based on 1 visit only and there was heterogeneity between the studies.
  
  
  CONCLUSIONS
  Several user-friendly screening tools could improve the screening of elevated BP in the pediatric population.
authors.affiliation: Department of Endocrinology, First Hospital of Qinhuangdao, Qinhuangdao, China.
authors.forename: Chunming
authors.initials: C
authors.lastname: Ma
authors.affiliation: Department of Endocrinology, First Hospital of Qinhuangdao, Qinhuangdao, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Wang
authors.affiliation: Department of Endocrinology, First Hospital of Qinhuangdao, Qinhuangdao, China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Endocrinology, First Hospital of Qinhuangdao, Qinhuangdao, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Lu
authors.affiliation: Department of Endocrinology, First Hospital of Qinhuangdao, Qinhuangdao, China.
authors.forename: Na
authors.initials: N
authors.lastname: Lu
authors.affiliation: Department of Endocrinology, First Hospital of Qinhuangdao, Qinhuangdao, China.
authors.forename: Yiming
authors.initials: Y
authors.lastname: Tian
authors.affiliation: Department of Endocrinology, First Hospital of Qinhuangdao, Qinhuangdao, China.
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Endocrinology, First Hospital of Qinhuangdao, Qinhuangdao, China yinfuzai62@163.com.
authors.forename: Fuzai
authors.initials: F
authors.lastname: Yin
mesh_terms: D000293:Adolescent; D001827:Body Height; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000517:prevention & control*; D008297:Male; D008403:Mass Screening / Q000379:methods*; D012016:Reference Values; D012680:Sensitivity and Specificity; D012737:Sex Factors