TY - JOUR T1 - Detection of coins ingested by children using a handheld metal detector: a systematic review JF - Emergency Medicine Journal JO - Emerg Med J SP - 839 LP - 844 DO - 10.1136/emj.2004.022301 VL - 22 IS - 12 AU - J B Lee AU - S Ahmad AU - C P Gale Y1 - 2005/12/01 UR - http://emj.bmj.com/content/22/12/839.abstract N2 - To determine if the use of a handheld metal detector (HHMD) can safely reduce the number of radiographs requested in cases of coins ingested by children, a search was performed to identify prospective studies of the ability of an HHMD to identify the presence or absence of ingested coin in children (17 years or younger). Outcome measures were presence or absence of coin on metal detector screening, and accuracy of coin localisation. Inclusion and exclusion criteria were defined. Mantel-Haenszel (fixed effect model) pooling with 95% confidence intervals (CI) was used to calculate overall sensitivities and specificities. In total, 11 studies met the inclusion criteria. The overall sensitivity of the HHMD at detecting the presence of coins was 99.4% (95% CI 98.0 to 99.9%) and accuracy at localisation was 99.8% (98.5 to 100.0%). The overall specificity of the HHMD was 100% (76.8 to 100%). Use of the HHMD is an accurate, radiation free, and cost effective method of identifying and localising coins ingested by children. An algorithm for investigating children with coin ingestion is proposed. ER -