A systematic review 1 including 11 diagnostic studies (prospective, blinded with an appropriate reference test) with a total of 739 children (17 years or younger) was abstracted in DARE. Outcome measures were presence or absence of coin on metal detector screening, and accuracy of coin localisation (abdomen or non-abdomen). Only data from doctor or radiographer operators, with prior instruction on how to use the handheld metal detector (HHMD), were used in the pooled analysis. The overall sensitivity of the HHMD at detecting the presence of coins was 99.4% (95% CI 98.0 to 99.9; based on 9 studies), with a corresponding specificity of 100% (95% CI 76.8 to 100). The accuracy at localisation was 99.8% (95% CI 98.5 to 100; based on 11 studies). The authors estimated that, based on PACS (Picture Archiving and Communications System) costs of neck, chest and abdominal radiographs, the cost of purchasing an HHMD would be recovered after four cases.
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