A meta-analysis of the reliability of the history in suspected poisoning

Abstract

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 deter- mine summary measures of reliability of history in sus- pected acute poisoning. Method: Relevant studies were selected from a search on the Medline database to perform a meta-analysis to calculate pooled estimates of k statistic for agreement between history of poisoning and laboratory diagnosis. Results: A total of seven articles were included in the meta-analysis. The k statistic varied from 0.35 (95% con- fidence 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.