Clinical features for diagnosis of pneumonia among adults in primary care setting: A systematic and meta-review

Abstract Pneumonia results in significant morbidity and mortality worldwide. However, chest radiography may not be accessible in primary care setting. We aimed to evaluate clinical features and its diagnostic value to identify pneumonia among adults in primary care settings. Three academic databases...

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Autores principales:	Tha Pyai Htun, Yinxiaohe Sun, Hui Lan Chua, Junxiong Pang
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2019
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/286288c7a31c4357894148ebcb7a9c1a
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spelling	oai:doaj.org-article:286288c7a31c4357894148ebcb7a9c1a2021-12-02T15:09:29ZClinical features for diagnosis of pneumonia among adults in primary care setting: A systematic and meta-review10.1038/s41598-019-44145-y2045-2322https://doaj.org/article/286288c7a31c4357894148ebcb7a9c1a2019-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-019-44145-yhttps://doaj.org/toc/2045-2322Abstract Pneumonia results in significant morbidity and mortality worldwide. However, chest radiography may not be accessible in primary care setting. We aimed to evaluate clinical features and its diagnostic value to identify pneumonia among adults in primary care settings. Three academic databases were searched and included studies that assessed clinical predictors of pneumonia, adults without serious illness, have CXR and have conducted in primary care settings. We calculated sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratio of each index test and the pool estimates for index tests. We identified 2,397 articles, of which 13 articles were included. In our meta-analysis, clinical features with the best pooled positive likelihood ratios were respiratory rate ≥20 min−1 (3.47; 1.46–7.23), temperature ≥38 °C (3.21; 2.36–4.23), pulse rate >100 min−1 (2.79; 1.71–4.33), and crackles (2.42; 1.19–4.69). Laboratory testing showed highest pooled positive likelihood ratios with PCT >0.25 ng/ml (7.61; 3.28–15.1) and CRP > 20 mg/l (3.76; 2.3–5.91). Cough, pyrexia, tachycardia, tachypnea, and crackles are limited as a single predictor for diagnosis of radiographic pneumonia among adults. Development of clinical decision rule that combine these clinical features together with molecular biomarkers may further increase overall accuracy for diagnosis of radiographic pneumonia among adults in primary care setting.Tha Pyai HtunYinxiaohe SunHui Lan ChuaJunxiong PangNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 9, Iss 1, Pp 1-10 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Tha Pyai Htun Yinxiaohe Sun Hui Lan Chua Junxiong Pang Clinical features for diagnosis of pneumonia among adults in primary care setting: A systematic and meta-review
description	Abstract Pneumonia results in significant morbidity and mortality worldwide. However, chest radiography may not be accessible in primary care setting. We aimed to evaluate clinical features and its diagnostic value to identify pneumonia among adults in primary care settings. Three academic databases were searched and included studies that assessed clinical predictors of pneumonia, adults without serious illness, have CXR and have conducted in primary care settings. We calculated sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratio of each index test and the pool estimates for index tests. We identified 2,397 articles, of which 13 articles were included. In our meta-analysis, clinical features with the best pooled positive likelihood ratios were respiratory rate ≥20 min−1 (3.47; 1.46–7.23), temperature ≥38 °C (3.21; 2.36–4.23), pulse rate >100 min−1 (2.79; 1.71–4.33), and crackles (2.42; 1.19–4.69). Laboratory testing showed highest pooled positive likelihood ratios with PCT >0.25 ng/ml (7.61; 3.28–15.1) and CRP > 20 mg/l (3.76; 2.3–5.91). Cough, pyrexia, tachycardia, tachypnea, and crackles are limited as a single predictor for diagnosis of radiographic pneumonia among adults. Development of clinical decision rule that combine these clinical features together with molecular biomarkers may further increase overall accuracy for diagnosis of radiographic pneumonia among adults in primary care setting.
format	article
author	Tha Pyai Htun Yinxiaohe Sun Hui Lan Chua Junxiong Pang
author_facet	Tha Pyai Htun Yinxiaohe Sun Hui Lan Chua Junxiong Pang
author_sort	Tha Pyai Htun
title	Clinical features for diagnosis of pneumonia among adults in primary care setting: A systematic and meta-review
title_short	Clinical features for diagnosis of pneumonia among adults in primary care setting: A systematic and meta-review
title_full	Clinical features for diagnosis of pneumonia among adults in primary care setting: A systematic and meta-review
title_fullStr	Clinical features for diagnosis of pneumonia among adults in primary care setting: A systematic and meta-review
title_full_unstemmed	Clinical features for diagnosis of pneumonia among adults in primary care setting: A systematic and meta-review
title_sort	clinical features for diagnosis of pneumonia among adults in primary care setting: a systematic and meta-review
publisher	Nature Portfolio
publishDate	2019
url	https://doaj.org/article/286288c7a31c4357894148ebcb7a9c1a
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Clinical features for diagnosis of pneumonia among adults in primary care setting: A systematic and meta-review

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