A Meta-Analysis of the Reliability of the History in Suspected Poisoning

Abstract Background 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 determine summary measures of reliability of history in suspected acute poisoning. Method Relevant studies were selected from a search on the Medline database to perform a meta-analysis to calculate pooled estimates of κ statistic for agreement between history of poisoning and laboratory diagnosis. Results A total of seven articles were included in the meta-analysis. The κ statistic varied from 0.35 (95% confidence 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.