Evidence map›Paper›PMID 34824286›Full record

ArticleNPJ primary care respiratory medicine2021

COVID-19 assessment in family practice-A clinical decision rule based on self-rated symptoms and contact history.

Antonius Schneider, Katharina Rauscher, Christina Kellerer, Klaus Linde, Frederike Kneissl, Alexander Hapfelmeier

Open access · goldAbstract read
In one paragraph

Article in NPJ primary care respiratory medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 31% 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

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
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

6 authors at 1 institution in 1 country.

Antonius SchneiderTUM School of Medicine, Institute of General Practice and Health Services Research, Technical University of Munich, Munich, Germany. antonius.schneider@tum.de.ORCID 0000-0002-2847-8626
Katharina RauscherTUM School of Medicine, Institute of General Practice and Health Services Research, Technical University of Munich, Munich, Germany.
Christina KellererTUM School of Medicine, Institute of General Practice and Health Services Research, Technical University of Munich, Munich, Germany.ORCID 0000-0002-0670-6392
Klaus LindeTUM School of Medicine, Institute of General Practice and Health Services Research, Technical University of Munich, Munich, Germany.
Frederike KneisslTUM School of Medicine, Institute of General Practice and Health Services Research, Technical University of Munich, Munich, Germany.
Alexander HapfelmeierTUM School of Medicine, Institute of General Practice and Health Services Research, Technical University of Munich, Munich, Germany.
Technical University of Munich · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The study aimed to evaluate the diagnostic accuracy of contact history and clinical symptoms and to develop decision rules for ruling-in and ruling-out SARS-CoV-2 infection in family practice. We performed a prospective diagnostic study. Consecutive inclusion of patients coming for COVID-PCR testing to 19 general practices. Contact history and self-reported symptoms served as index test. PCR testing of nasopharyngeal swabs served as reference standard. Complete data were available from 1141 patients, 605 (53.0%) female, average age 42.2 years, 182 (16.0%) COVID-PCR positive. Multivariable logistic regression showed highest odds ratios (ORs) for "contact with infected person" (OR 9.22, 95% CI 5.61-15.41), anosmia/ageusia (8.79, 4.89-15.95), fever (4.25, 2.56-7.09), and "sudden disease onset" (2.52, 1.55-4.14). Patients with "contact with infected person" or "anosmia/ageusia" with or without self-reported "fever" had a high probability of COVID infection up to 84.8%. Negative response to the four items "contact with infected person, anosmia/ageusia, fever, sudden disease onset" showed a negative predictive value (NPV) of 0.98 (95% CI 0.96-0.99). This was present in 446 (39.1%) patients. NPV of "completely asymptomatic," "no contact," "no risk area" was 1.0 (0.96-1.0). This was present in 84 (7.4%) patients. To conclude, the combination of four key items allowed exclusion of SARS-CoV-2 infection with high certainty. With the goal of 100% exclusion of SARS-CoV-2 infection to prevent the spread of SARS-CoV-2 to the population level, COVID-PCR testing could be saved only for patients with negative response in all items. The decision rule might also help for ruling-in SARS-CoV-2 infection in terms of rapid assessment of infection risk.

Indexed as

COVID-19AdultClinical Decision RulesFamily PracticeFemaleHumansProspective StudiesSARS-CoV-2

Identifiers

PMID34824286
PMCPMC8617029
OpenAlexW3215376663

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.