Point-of-care diagnostic test accuracy in children and adolescents with sickle cell disease: A systematic review and meta-analysis

BACKGROUND: Detection of sickle cell disease (SCD) could be improved with greater use of point-of-care testing (POCT). This review assessed the accuracy of POCTs for SCD in children and adolescents. METHODS: We systematically searched EMBASE, PubMed, Cochrane libraries, registries and conference proceedings from inception to 28th February 2023. We included cross-sectional and case-control studies that tested for SCD using POCTs and reference tests in individuals aged 0-19. We conducted meta-analysis to assess sensitivity and specificity of individual POCTs. FINDINGS: The review included 31 studies overall, with 20 covering lateral flow immunoassays (LFIAs) and four covering micro-engineered electrophoresis. When detecting homozygous SCD, the pooled sensitivity and specificity of the included LFIAs and micro-engineered electrophoresis POCTs was 92 % or higher in all individual meta-analyses. Sensitivities and specificities were also nearly 100 % when detecting haemoglobin SC disease for these POCTs. INTERPRETATION: POCTs could be used to accurately diagnose SCD.