SynthesisBMJ (Clinical research ed.)2005
Diagnostic value of C reactive protein in infections of the lower respiratory tract: systematic review.
Synthesis in BMJ (Clinical research ed.), 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03322670 (Description of Pneumococcal Community-acquired Pneumonia in General Practice in France), which is not on this map. Cited by 95 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Description of Pneumococcal Community-acquired Pneumonia in General Practice in France
Who cites it
95 citing papers in PubMed, 6 syntheses or guidelines pooled it, 245 citations in OpenAlex.
- Diagnostic accuracy of point-of-care tests for acute respiratory infection: a systematic review of reviews.Health technology assessment (Winchester, England) · 2026Pooled it
- Prognostic value of C-reactive protein levels in pulmonary infections: A systematic review and meta-analysis.Medicine · 2025Pooled it
- Biomarkers as point-of-care tests to guide prescription of antibiotics in people with acute respiratory infections in primary care.The Cochrane database of systematic reviews · 2022Pooled it
- Guidelines for the management of adult lower respiratory tract infections--full version.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2011Guideline
- Guideline
- Pandemic flu. Clinical management of patients with an influenza-like illness during an influenza pandemic.The Journal of infection · 2006Guideline
- A novel host-proteome signature for distinguishing between acute bacterial and viral infections.PloS one · 2015Trial
- Procalcitonin guidance for reduction of antibiotic use in patients hospitalized with severe acute exacerbations of asthma: a randomized controlled study with 12-month follow-up.Critical care (London, England) · 2014Trial
- Effects of internet-based training on antibiotic prescribing rates for acute respiratory-tract infections: a multinational, cluster, randomised, factorial, controlled trial.Lancet (London, England) · 2013Trial
- Trial
- Effect of point of care testing for C reactive protein and training in communication skills on antibiotic use in lower respiratory tract infections: cluster randomised trial.BMJ (Clinical research ed.) · 2009Trial
- Improving management of patients with acute cough by C-reactive protein point of care testing and communication training (IMPAC3T): study protocol of a cluster randomised controlled trial.BMC family practice · 2007Trial
- Enhanced communication skills and C-reactive protein point-of-care testing for respiratory tract infection: 3.5-year follow-up of a cluster randomized trial.Annals of family medicineTrial
- Point-of-care C-reactive protein testing and antibiotic prescribing for respiratory tract infections: a randomized controlled trial.Annals of family medicineTrial
- Flow Cytometric Lymphocyte Subset Enumeration for Lymphopenia Grading and C-Reactive Protein-Defined Inflammation Discrimination.Journal of clinical laboratory analysis · 2026Article
- Clinical analyses of angiotensin-converting enzyme inhibitor users presenting with cough to a chest diseases outpatient clinic: A single-center retrospective study.The Journal of international medical research · 2026Article
- Host-microbiome archetypes differentiate infection from pathogen carriage in the human lower airway.Nature communications · 2026Article
- Clinical Gestalt to Predict Bacterial Infection and Mortality in Emergency Department Patients: A Prospective Observational Study.Journal of general internal medicine · 2026Observational
- Integrating a host biomarker with a large language model for diagnosis of lower respiratory tract infection.Nature communications · 2025Article
- Performance evaluation of a point of care capillary blood test for C-reactive protein in community healthcare.BMC primary care · 2025Article
35 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo evaluate the diagnostic accuracy of C reactive protein in detecting radiologically proved pneumonia and to evaluate how well it can discriminate between bacterial and viral infections of the lower respiratory tract. DATA SOURCES: Medline and Embase (January 1966 to April 2004), with reference checking. STUDY SELECTION: We included articles comparing C reactive protein with a chest radiograph or with microbiological work-up as a reference test. Two authors independently assessed methodological items.
resultsNone of the studies met all validity criteria. Six studies used an infiltrate on chest radiograph as reference test. Sensitivities ranged from 10% to 98%, specificities from 44% to 99%. For adults, the relation of C reactive protein with an infiltrate (in a subgroup analysis of five studies) showed an area under the curve of 0.80 (95% confidence interval 0.75 to 0.85). In 12 studies, the relation of C reactive protein with a bacterial aetiology of infection of the lower respiratory tract was studied. Sensitivities ranged from 8% to 99%, specificities from 27% to 95%. These data were epidemiologically and statistically heterogeneous, so overall outcomes could not be calculated.
conclusionTesting for C reactive protein is neither sufficiently sensitive to rule out nor sufficiently specific to rule in an infiltrate on chest radiograph and bacterial aetiology of lower respiratory tract infection. The methodological quality of the diagnostic studies is generally poor. The evidence not consistently and sufficiently supports a wide introduction of C reactive protein as a rapid test to guide antibiotics prescription.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.