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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 ★★★★☆☆☆
METHODS
Design:
blinded comparison of chest radiographs with general practitioner (GP) assessed diagnosis.
Setting:
15 general practices (25 GPs) in the Netherlands.
Patients:
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.
Description 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.
Diagnostic standard:
chest radiography (lateral and postero anterior) was used as the diagnostic standard for identifying pneumonia.
Outcomes:
diagnostic characteristics for the performances of the …
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