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Symptoms and signs plus erythrocyte sedimentation rate or C-reactive protein predicted pneumonia in lower respiratory tract infection

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 Q In adults with a lower respiratory tract infection (LRTI), which symptoms, signs, and tests best inform the diagnosis of pneumonia?

Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ Emergency medicine ★★★★★☆☆ Internal medicine ★★★★☆☆☆ Respirology ★★★★☆☆☆ Infectious disease ★★★★☆☆☆


Embedded ImageDesign:

blinded comparison of chest radiographs with general practitioner (GP) assessed diagnosis.

Embedded ImageSetting:

15 general practices (25 GPs) in the Netherlands.

Embedded ImagePatients:

246 patients aged ⩾18 years (mean age 52 y) presenting to a GP with an LRTI. Exclusion criteria included severe clinical disease, recent antibiotic treatment, or hospital admission for respiratory disease.

Embedded ImageDescription of tests:

the clinical status of patients (classified as either pneumonia or other LRTI) was based on clinical symptoms and signs, and C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) blood tests.

Embedded ImageDiagnostic standard:

chest radiography (lateral and postero anterior) was used as the diagnostic standard for identifying pneumonia.

Embedded ImageOutcomes:

diagnostic characteristics for the performances of the …

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