ArticleCritical care (London, England)2015
Diagnostic accuracy of C-reactive protein and procalcitonin in suspected community-acquired pneumonia adults visiting emergency department and having a systematic thoracic CT scan.
Article in Critical care (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 37 papers, 2 of them syntheses that pooled it.
What it found
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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.
Chest CT-scan for the Diagnosis of Community-acquired Pneumonia in Patients Visiting the Emergency Department
Description of Pneumococcal Community-acquired Pneumonia in General Practice in France
Procalcitonin at Zero and 24 Hours as a Prognostic Factor in Patients With Pneumonia
Who cites it
37 citing papers in PubMed, 2 syntheses or guidelines pooled it, 80 citations in OpenAlex.
- Pooled it
- Systematic review of respiratory viral pathogens identified in adults with community-acquired pneumonia in Europe.Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology · 2017Pooled it
- Efficacy and safety of trimodulin, a novel polyclonal antibody preparation, in patients with severe community-acquired pneumonia: a randomized, placebo-controlled, double-blind, multicenter, phase II trial (CIGMA study).Intensive care medicine · 2018Trial
- Is C-reactive protein the answer to antibiotics over-prescribing in primary care? A behavioural experiment in two European countries.JAC-antimicrobial resistance · 2026Article
- ERS/ESCMID state-of-the-science statement on the role of rapid diagnostic tests for the diagnosis and management of community-acquired lower respiratory tract infections.The European respiratory journal · 2026Review
- Serum mass spectral fingerprints with machine learning for early discrimination of infectious pneumonia in the emergency department.BMC infectious diseases · 2026Observational
- Host-pathogen interaction in community-acquired pneumonia: a focus on the immune response.Frontiers in cellular and infection microbiology · 2026Review
- Heart murmurs in the general population: diagnostic value and prevalence from the Tromsø Study.Heart (British Cardiac Society) · 2025Article
- Description and characterization of pneumococcal community acquired pneumonia (CAP) among radiologically confirmed CAP in outpatients.NPJ primary care respiratory medicine · 2025Observational
- The assessment of pentraxin 3: a diagnostic and prognostic biomarker in lower respiratory tract infections in children.Italian journal of pediatrics · 2024Article
- Accuracy of the Infectious Diseases Society of America and British Thoracic Society Criteria for Acute Pneumonia in Differentiating Chemical and Bacterial Complications of Aspiration in Comatose Ventilated Patients Following Drug Poisoning.Antibiotics (Basel, Switzerland) · 2024Article
- Misleading Procalcitonin in Patients With Staphylococcus aureus Bacteremia: A Report of Two Cases.Cureus · 2023Article
- Interest of Absolute Eosinopenia as a Marker of Influenza in Outpatients during the Fall-Winter Seasons 2016-2018 in the Greater Paris Area: The SUPERFLUOUS Study.Diagnostics (Basel, Switzerland) · 2023Article
- Lung Ultrasound in Coronary Care Unit, an Important Diagnostic Tool for Concomitant Pneumonia.Diagnostics (Basel, Switzerland) · 2022Article
- Multi-branch fusion auxiliary learning for the detection of pneumonia from chest X-ray images.Computers in biology and medicine · 2022Article
- ARDS Clinical Practice Guideline 2021.Journal of intensive care · 2022Article
- Host protease activity classifies pneumonia etiology.Proceedings of the National Academy of Sciences of the United States of America · 2022Article
- Relationship between biomarkers and findings on low-dose computed tomography in hospitalised patients with acute exacerbation of COPD.ERJ open research · 2022Article
- Does procalcitonin have clinical utility in the management of paediatric community-acquired pneumonia? A PRO/CON debate.JAC-antimicrobial resistance · 2021Review
- Salivary C-Reactive Protein and Mean Platelet Volume in the Diagnosis and Follow-Up of Community-Acquired Pneumonia in Infants.Pediatric allergy, immunology, and pulmonology · 2021Observational
Corrections and comments
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Authors and funding
11 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionCommunity-acquired pneumonia (CAP) requires prompt treatment, but its diagnosis is complex. Improvement of bacterial CAP diagnosis by biomarkers has been evaluated using chest X-ray infiltrate as the CAP gold standard, producing conflicting results. We analyzed the diagnostic accuracy of biomarkers in suspected CAP adults visiting emergency departments for whom CAP diagnosis was established by an adjudication committee which founded its judgment on a systematic multidetector thoracic CT scan.
methodsIn an ancillary study of a multi-center prospective study evaluating the impact of systematic thoracic CT scan on CAP diagnosis, sensitivity and specificity of C-reactive protein (CRP) and procalcitonin (PCT) were evaluated. Systematic nasopharyngeal multiplex respiratory virus PCR was performed at inclusion. An adjudication committee classified CAP diagnostic probability on a 4-level Likert scale, based on all available data.
resultsTwo hundred patients with suspected CAP were analyzed. The adjudication committee classified 98 patients (49.0 %) as definite CAP, 8 (4.0 %) as probable, 23 (11.5 %) as possible and excluded in 71 (35.5 %, including 29 patients with pulmonary infiltrates on chest X-ray). Among patients with radiological pulmonary infiltrate, 23 % were finally classified as excluded. Viruses were identified by PCR in 29 % of patients classified as definite. Area under the curve was 0.787 [95 % confidence interval (95 % CI), 0.717 to 0.857] for CRP and 0.655 (95 % CI, 0.570 to 0.739) for PCT to detect definite CAP. CRP threshold at 50 mg/L resulted in a positive predictive value of 0.76 and a negative predictive value of 0.75. No PCT cut-off resulted in satisfactory positive or negative predictive values. CRP and PCT accuracy was not improved by exclusion of the 25 (25.5 %) definite viral CAP cases.
conclusionsFor patients with suspected CAP visiting emergency departments, diagnostic accuracy of CRP and PCT are insufficient to confirm the CAP diagnosis established using a gold standard that includes thoracic CT scan. Diagnostic accuracy of these biomarkers is also insufficient to distinguish bacterial CAP from viral CAP.
trial registrationClinicalTrials.gov registry NCT01574066 (February 7, 2012).
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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.