Evidence map›Paper›PMID 32563600›Full record

Observational studyAnnals of emergency medicine2020

Accuracy of Emergency Department Clinical Findings for Diagnosis of Coronavirus Disease 2019.

Olivier Peyrony, Carole Marbeuf-Gueye, Vy Truong, Marion Giroud, Clémentine Rivière, Khalil Khenissi, Léa Legay, Marie Simonetta, Arben Elezi, Alessandra Principe and 5 more

Open access · bronzeAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Annals of emergency medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
54citing papers in PubMed, 7 pooled it
2.0field-weighted citation impact, top 8% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

54 citing papers in PubMed, 7 syntheses or guidelines pooled it, 85 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 2 institutions in 1 country.

Olivier PeyronyEmergency Department, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France. Electronic address: o.peyrony@hotmail.fr.
Carole Marbeuf-GueyeEmergency Department, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Vy TruongEmergency Department, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Marion GiroudEmergency Department, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Clémentine RivièreEmergency Department, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Khalil KhenissiEmergency Department, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Léa LegayEmergency Department, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Marie SimonettaEmergency Department, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Arben EleziEmergency Department, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Alessandra PrincipeEmergency Department, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Pierre TabouletEmergency Department, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Carl OgereauEmergency Department, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Mathieu TourdjmanSanté Publique France, Paris, France; Emergency Department, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Sami EllouzeEmergency Department, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Jean-Paul FontaineEmergency Department, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Assistance Publique – Hôpitaux de Paris · FRSanté Publique France · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

objectiveWe seek to describe the medical history and clinical findings of patients attending the emergency department (ED) with suspected coronavirus disease 2019 (COVID-19) and estimate the diagnostic accuracy of patients' characteristics for predicting COVID-19.

methodsWe prospectively enrolled all patients tested for severe acute respiratory syndrome coronavirus 2 by reverse-transcriptase polymerase chain reaction in our ED from March 9, 2020, to April 4, 2020. We abstracted medical history, physical examination findings, and the clinical probability of COVID-19 (low, moderate, and high) rated by emergency physicians, depending on their clinical judgment. We assessed diagnostic accuracy of these characteristics for COVID-19 by calculating positive and negative likelihood ratios.

resultsWe included 391 patients, of whom 225 had positive test results for severe acute respiratory syndrome coronavirus 2. Reverse-transcriptase polymerase chain reaction result was more likely to be negative when the emergency physician thought that clinical probability was low, and more likely to be positive when he or she thought that it was high. Patient-reported anosmia and the presence of bilateral B lines on lung ultrasonography had the highest positive likelihood ratio for the diagnosis of COVID-19 (7.58, 95% confidence interval [CI] 2.36 to 24.36; and 7.09, 95% CI 2.77 to 18.12, respectively). The absence of a high clinical probability determined by the emergency physician and the absence of bilateral B lines on lung ultrasonography had the lowest negative likelihood ratio for the diagnosis of COVID-19 (0.33, 95% CI 0.25 to 0.43; and 0.26, 95% CI 0.15 to 0.45, respectively).

conclusionAnosmia, emergency physician estimate of high clinical probability, and bilateral B lines on lung ultrasonography increased the likelihood of identifying COVID-19 in patients presenting to the ED.

Indexed as

Clinical Laboratory TechniquesAdultAgedBetacoronavirusCoronavirus InfectionsCOVID-19COVID-19 TestingEmergency Service, HospitalFemaleFranceHumansLungMaleMedical History TakingMiddle AgedOlfaction Disorders

Identifiers

PMID32563600
PMCPMC7241345
OpenAlexW3028249840

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.