Evidence map›Paper›PMID 34990385›Full record

Trial reportThe British journal of general practice : the journal of the Royal College of General Practitioners2022

Clinical presentation, microbiological aetiology and disease course in patients with flu-like illness: a post hoc analysis of randomised controlled trial data.

Theo J Verheij, Daniela Cianci, Alike W van der Velden, Christopher C Butler, Emily Bongard, Samuel Coenen, Annelies Colliers, Nick A Francis, Paul Little, Maciek Godycki-Cwirko and 19 more

Open access · hybridAbstract readRandomized Controlled TrialPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The British journal of general practice : the journal of the Royal College of General Practitioners, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.6field-weighted citation impact, top 30% 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

4 citing papers in PubMed, 5 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. 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

29 authors at 10 institutions in 10 countries.

Theo J VerheijJulius Center for Health Science and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Daniela CianciJulius Center for Health Science and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Alike W van der VeldenJulius Center for Health Science and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Christopher C ButlerNuffield Department of Primary Care, University of Oxford Medical Sciences Division, Oxford, UK.
Emily BongardNuffield Department of Primary Care, University of Oxford Medical Sciences Division, Oxford, UK.
Samuel CoenenDepartment of Primary and Interdisciplinary Care (ELIZA) - Centre for General Practice, University of Antwerp Faculty of Medicine and Health Sciences, Antwerp, Belgium.
Annelies ColliersDepartment of Primary and Interdisciplinary Care (ELIZA) - Centre for General Practice, University of Antwerp Faculty of Medicine and Health Sciences, Antwerp, Belgium.
Nick A FrancisPrimary Care and Population Sciences, University of Southampton, Southampton, UK.
Paul LittlePrimary Care and Population Sciences, University of Southampton, Southampton, UK.
Maciek Godycki-CwirkoDivision of Public Health, Centre for Family and Community Medicine, Medical University of Lodz, Lodz, Poland.
Carl LlorUniversity of Copenhagen, Copenhagen, Denmark; University Institute in Primary Care Research Jordi Gol, Via Roma Health Centre, Barcelona, Spain.
Sławomir ChlabiczDepartment of Family Medicine, Medical University of Bialystok, Bialystok, Poland.
Christos LionisClinic of Social and Family Medicine, University of Crete School of Medicine, Heraklion, Greece.
Pär-Daniel SundvallResearch and Development Primary Health Care, Västra Götalandsregionen, University of Gothenburg; Sahlgrenska Academy, Department of Public Health and Community Medicine/Primary Health Care, Institute of Medicine, Gothenburg, Sweden.
Lars BjerrumUniversity of Copenhagen, Copenhagen, Denmark.
An De SutterDepartment of Public Health and Primary Care, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium.
Rune AabenhusUniversity of Copenhagen, Copenhagen, Denmark.
Nicolay Jonassen HarbinAntibiotic Center for Primary Care, Department of General Practice, Faculty of Medicine, University of Oslo, Oslo, Norway.
Morten LindbækAntibiotic Center for Primary Care, Department of General Practice, Faculty of Medicine, University of Oslo, Oslo, Norway.
Dominik GlinzInstitute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland.
Heiner C BucherInstitute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland.
Bernadett KovácsDrug Research Center, Balatonfüred, Hungary.
Bohumil SeifertDepartment of General Practice, Charles University, Prague, Czech Republic.
Ruta Radzeviciene JurguteJSC Mano Seimos Gydytojas, Klaipeda, Lithuania.
Pia Touboul LundgrenDépartment de Santé Publique, Université Côte d'Azur Faculté de Médecine, Nice, France.
Muireann de PaorRoyal College of Surgeons in Ireland, Dublin, Ireland.
Veerle MatheeussenLaboratory of Medical Microbiology, Vaccine & Infectious Diseases Institute, University Hospital Antwerp, Antwerp, Belgium.
Herman GoossensLaboratory of Medical Microbiology, Vaccine & Infectious Diseases Institute, University Hospital Antwerp, Antwerp, Belgium.
Margareta IevenLaboratory of Medical Microbiology, Vaccine & Infectious Diseases Institute, University Hospital Antwerp, Antwerp, Belgium.
University Medical Center Utrecht · NLUniversity Hospital of Basel · CHUniversity of Copenhagen · DKUniversity of Southampton · GBCharles University · CZGhent University · BEHUN-REN Balaton Limnological Research Institute · HUMedical University of Białystok · PLRoyal College of Surgeons in Ireland · IEUniversity of Crete · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is little evidence about the relationship between aetiology, illness severity, and clinical course of respiratory tract infections (RTIs) in primary care. Understanding these associations would aid in the development of effective management strategies for these infections.

aimTo investigate whether clinical presentation and illness course differ between RTIs where a viral pathogen was detected and those where a potential bacterial pathogen was found. DESIGN AND

settingPost hoc analysis of data from a pragmatic randomised trial on the effects of oseltamivir in patients with flu-like illness in primary care (

methodPatient characteristics and their signs and symptoms of disease were registered at baseline. Nasopharyngeal (adults) or nasal and pharyngeal (children) swabs were taken for polymerase chain reaction analysis. Patients were followed up until 28 days after inclusion. Regression models and Kaplan-Meier curves were used to analyse the relationship between aetiology, clinical presentation at baseline, and course of disease including complications.

resultsExcept for a less prominent congested nose (odds ratio [OR] 0.55, 95% confidence interval [CI] = 0.35 to 0.86) and acute cough (OR 0.42, 95% CI = 0.27 to 0.65) in patients with flu-like illness in whom a possible bacterial pathogen was isolated, there were no clear clinical differences in presentations between those with a possible bacterial aetiology compared with those with a viral aetiology. Also, course of disease and complications were not related to aetiology.

conclusionGiven current available microbiological tests and antimicrobial treatments, and outside pandemics such as COVID-19, microbiological testing in primary care patients with flu-like illness seems to have limited value. A wait-and-see policy in most of these patients with flu-like illness seems the best option.

Indexed as

COVID-19Respiratory Tract InfectionsVirus DiseasesAdultChildHumansPandemicsSARS-CoV-2diagnosisoseltamivirprimary health carerandomised controlled trialrespiratory tract infections

Identifiers

PMID34990385
PMCPMC8803087
OpenAlexW4200228410

What OpenQuestion holds

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Registered trials

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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.