CRP cut point (mg/L), ≥ | Sensitivity (95% CI) | Specificity (95% CI) | Youden’s index | Area under the curve | Reference standard(s) | Total Patients, n | Disease, n* | Studies, n | I2 |
All included studies | |||||||||
6 | 0.76 (0.69 to 0.81) | 0.77 (0.69 to 0.83) | 0.53 | 0.83 (0.76, 0.85) | Blood culture and clinical sepsis | 2910 | 1122 | 24 | 2.9–4.2 |
10 | 0.68 (0.61 to 0.74) | 0.81 (0.76 to 0.86) | 0.49 | 0.80 (0.73, 0.82) | Blood culture and clinical sepsis | 8243 | 1829 | 38 | 8.2–10.9 |
60 | 0.78 (0.67 to 0.86) | 0.80 (0.66 to 0.89) | 0.58 | 0.85 (0.73, 0.90) | Blood culture and clinical sepsis | 1389 | 576 | 10 | 8–11.3 |
2.5 | 0.76 (0.58 to 0.88) | 0.86 (0.32 to 0.99) | 0.62 | 0.83 (0.70, 0.93) | Blood culture | 263 | 124 | 3 | 0.4–0.5 |
5 | 0.79 (0.62 to 0.89) | 0.76 (0.58 to 0.88) | 0.55 | 0.84 (0.72, 0.89) | Blood culture | 1003 | 355 | 8 | 4.1–7 |
6 | 0.77 (0.69 to 0.83) | 0.76 (0.68 to 0.83) | 0.53 | 0.83 (0.75, 0.85) | Blood culture | 2600 | 942 | 21 | 3.4–5.2 |
8 | 0.54 (0.40 to 0.68) | 0.86 (0.77 to 0.92) | 0.40 | 0.78 (0.65, 0.84) | Blood culture | 1866 | 356 | 10 | 3.6–4 |
10 | 0.69 (0.61 to 0.75) | 0.81 (0.74 to 0.86) | 0.50 | 0.81 (0.73, 0.82) | Blood culture | 7920 | 1733 | 35 | 8.3–11.2 |
20 | 0.79 (0.67 to 0.88) | 0.73 (0.58 to 0.84) | 0.52 | 0.83 (0.73, 0.86) | Blood culture | 3603 | 251 | 8 | 1.5–1.7 |
50 | 0.73 (0.40 to 0.91) | 0.83 (0.63 to 0.94) | 0.56 | 0.86 (0.60, 0.94) | Blood culture | 963 | 596 | 6 | 10.7–19.5 |
100 | 0.69 (0.35 to 0.91) | 0.87 (0.35 to 0.99) | 0.56 | 0.83 (0.47, 0.96) | Blood culture | 539 | 220 | 3 | 6.9–8.1 |
10 | 0.62 (0.50 to 0.73) | 0.87 (0.76 to 0.94) | 0.49 | 0.77 (0.57, 0.91) | Clinical sepsis | 323 | 96 | 4 | 3.4–3.6 |
High-income countries only | |||||||||
10 | 0.67 (0.57 to 0.75) | 0.81 (0.73 to 0.87) | 0.48 | 0.80 (0.71, 0.83) | Blood culture and clinical sepsis | 5997 | 994 | 26 | 9.5–12.5 |
8 | 0.58 (0.39 to 0.75) | 0.87 (0.73 to 0.94) | 0.45 | 0.80 (0.70, 0.86) | Blood culture | 1414 | 239 | 7 | 1.8–1.9 |
10 | 0.67 (0.57 to 0.76) | 0.81 (0.73 to 0.87) | 0.48 | 0.80 (0.71, 0.83) | Blood culture | 5924 | 964 | 25 | 9.8–12.8 |
20 | 0.79 (0.65 to 0.89) | 0.73 (0.56 to 0.85) | 0.52 | 0.83 (0.71, 0.87) | Blood culture | 3556 | 226 | 7 | 1.9–2.3 |
30 | 0.47 (0.35 to 0.59) | 0.84 (0.80 to 0.88) | 0.31 | 0.59 (0.46, 0.87) | Blood culture | 366 | 66 | 3 | 0 |
Low- and middle-income countries only | |||||||||
6 | 0.76 (0.71 to 0.81) | 0.76 (0.67 to 0.83) | 0.52 | 0.82 (0.74, 0.84) | Blood culture and clinical sepsis | 2775 | 1046 | 21 | 2.8–4.1 |
10 | 0.70 (0.62 to 0.76) | 0.82 (0.72 to 0.89) | 0.52 | 0.79 (0.66, 0.84) | Blood culture and clinical sepsis | 2274 | 835 | 12 | 5–6.7 |
60 | 0.78 (0.67 to 0.86) | 0.8 (0.66 to 0.89) | 0.58 | 0.85 (0.73, 0.90) | Blood culture and clinical sepsis | 1389 | 576 | 10 | 8–11.3 |
5 | 0.80 (0.62 to 0.91) | 0.76 (0.56 to 0.89) | 0.56 | 0.85 (0.72, 0.90) | Blood culture | 863 | 303 | 7 | 4.6–8 |
6 | 0.77 (0.70 to 0.83) | 0.74 (0.65 to 0.82) | 0.51 | 0.82 (0.74, 0.85) | Blood culture | 2465 | 866 | 18 | 3.4–5.1 |
8 | 0.44 (0.34 to 0.55) | 0.82 (0.76 to 0.87) | 0.26 | 0.72 (0.43, 0.84) | Blood culture | 452 | 117 | 3 | 10.8–11.7 |
10 | 0.71 (0.61 to 0.79) | 0.79 (0.67 to 0.88) | 0.50 | 0.80 (0.68, 0.85) | Blood culture | 2024 | 769 | 10 | 5.2–7.4 |
12 | 0.67 (0.49 to 0.81) | 0.88 (0.58 to 0.98) | 0.55 | 0.78 (0.60, 0.93) | Blood culture | 303 | 89 | 4 | 5.8–6.3 |
50 | 0.79 (0.38 to 0.96) | 0.72 (0.50 to 0.87) | 0.51 | 0.80 (0.48, 0.94) | Blood culture | 752 | 558 | 4 | 10.7–25 |
60 | 0.80 (0.71 to 0.87) | 0.82 (0.70 to 0.90) | 0.62 | 0.87 (0.76, 0.91) | Blood culture | 1339 | 555 | 9 | 5.9–8.4 |
10 | 0.66 (0.52 to 0.77) | 0.89 (0.71 to 0.96) | 0.55 | 0.74 (0.59, 0.93) | Clinical sepsis | 250 | 66 | 3 | 0.8–0.9 |
*Defined as positive for disease using reference standard.