SynthesisThe British journal of general practice : the journal of the Royal College of General Practitioners2016
Diagnosis of acute rhinosinusitis in primary care: a systematic review of test accuracy.
Synthesis in The British journal of general practice : the journal of the Royal College of General Practitioners, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 32 citations in OpenAlex.
- External validation of risk scores and multivariate models for the diagnosis of community-acquired pneumonia in outpatients.The European journal of general practice · 2026Article
- The decision-making process in general practice of when to use antibiotics to treat acute rhinosinusitis.Scandinavian journal of primary health care · 2026Article
- An Epidemiological Study on the Effectiveness of Nasturtium Herb and Horseradish Root (AngocinAntibiotics (Basel, Switzerland) · 2026Article
- Machine Learning-Enhanced Clinical Decision Support for Diagnosing Sinusitis With Nasal Endoscopy.International forum of allergy & rhinology · 2026Article
- Association of C-reactive protein with cause, duration and severity of lower respiratory infections in primary care: a prospective cohort study.BMJ open respiratory research · 2025Article
- Moving from a pilot study to large pragmatic trial in primary care settings: A study on acute rhinosinusitis.Journal of clinical and translational science · 2025Article
- Collaboration between otolaryngologists and oral surgeons in maxillary sinus elevation planning.Clinical implant dentistry and related research · 2024Review
- Does acute isolated sphenoidal sinusitis meet the criteria of the recent acute sinusitis guidelines, EPOS2020?European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2024Article
- Gas Monitoring in Human Frontal Sinuses-Stability Considerations and Gas Exchange Studies.Sensors (Basel, Switzerland) · 2021Article
- Common Cold and Acute Rhinosinusitis: Up-to-Date Management in 2020.Current allergy and asthma reports · 2020Review
- Accuracy of Signs and Symptoms for the Diagnosis of Acute Rhinosinusitis and Acute Bacterial Rhinosinusitis.Annals of family medicine · 2019Review
- [Twenty-five myths in infectious diseases in primary care associated with overdiagnosis and overtreatment].Atencion primaria · 2018Review
- C-reactive protein: guiding antibiotic prescribing decisions at the point of care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018Article
- Outpatient Antibiotic Stewardship: A Growing Frontier-Combining Myxovirus Resistance Protein A With Other Biomarkers to Improve Antibiotic Use.Open forum infectious diseases · 2018Article
- Overuse of diagnostic tools and medications in acute rhinosinusitis in Spain: a population-based study (the PROSINUS study).BMJ open · 2018Observational
- Proposed Clinical Decision Rules to Diagnose Acute Rhinosinusitis Among Adults in Primary Care.Annals of family medicine · 2017Article
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
backgroundAcute rhinosinusitis (ARS) is a common primary care infection, but there have been no recent, comprehensive diagnostic meta-analyses.
aimTo determine the accuracy of laboratory and imaging studies for the diagnosis of ARS. DESIGN AND
settingSystematic review of diagnostic tests in outpatient, primary care, and specialty settings.
methodThe authors included studies of patients presenting with or referred for suspected ARS, and used bivariate meta-analysis to calculate summary estimates of test accuracy and the area under the receiver operating characteristic (ROC) curve. The authors also plotted summary ROC curves to explore heterogeneity, cutoffs, and the impact of different reference standards.
resultsUsing antral puncture as the reference standard, A mode ultrasound (positive likelihood ratio [LR+] 1.71, negative likelihood ratio [LR-] 0.41), B mode ultrasound (LR+ 1.64, LR- 0.69), and radiography (LR+ 2.01, LR- 0.28) had only modest accuracy. Accuracy was higher using imaging as the reference standard for both ultrasound (LR+12.4, LR- 0.35) and radiography (LR+ 9.4, LR- 0.27), although this likely overestimates accuracy. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) both had clear threshold effects, and modest overall accuracy. The LR+ for ESR >30 and >40 were 4.08 and 7.40, respectively. A dipstick of nasal secretions for leucocyte esterase was highly accurate (LR+ 18.4, LR- 0.17) but has not been validated.
conclusionIn general, tests were of limited value in the diagnosis of ARS. Normal radiography helps rule out sinusitis when negative, whereas CRP and ESR help rule in sinusitis when positive, although, given their limited accuracy as individual tests, they cannot be routinely recommended. Prospective studies integrating signs and symptoms with point-of-care CRP, dipstick, and/ or handheld B-mode ultrasound are needed.
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.