Evidence map›Paper›PMID 41888890›Full record

ArticleSystematic reviews2026

Clinical assessment and biomarkers for the detection of bacterial community-acquired pneumonia in children and adults: a protocol for systematic review of diagnostic accuracy.

Jefferson Daniel, Mukesh Kumar Sathya Narayanan, Vignes Anand Srinivasalu, Adhin Bhaskar, Sharon Suresh, Bella Devaleenal Daniel, Balaji Ramraj, Dina Nair, Ranjit Immanuel James, Sudharsan Vasudevan and 2 more

Abstract read
In one paragraph

Article in Systematic reviews, 2026. 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
–field-weighted citation impact
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.

  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

12 authors.

Jefferson DanielDepartment of Pulmonary Medicine, Christian Medical College, Vellore, India.
Mukesh Kumar Sathya NarayananDepartment of Epidemiology, ICMR-National Institute for Research in Tuberculosis, Chennai, India.
Vignes Anand SrinivasaluDepartment of Clinical Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India.
Adhin BhaskarDepartment of Statistics, ICMR-National Institute for Research in Tuberculosis, Chennai, India.
Sharon SureshDepartment of Clinical Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India.
Bella Devaleenal DanielDepartment of Clinical Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India.
Balaji RamrajDepartment of Clinical Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India.
Dina NairDepartment of Clinical Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India.
Ranjit Immanuel JamesDepartment of Forensic Medicine and Toxicology, Christian Medical College, Vellore, India.
Sudharsan VasudevanNational Tuberculosis Elimination Program, World Health Organization, New Delhi, India.
Banurekha VelayuthamDepartment of Clinical Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India.
Leeberk Raja InbarajDepartment of Clinical Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India. leeberk2003@gmail.com.ORCID 0000-0001-8642-1348

Funding

Department of Health Research, India Centre for Evidence-based guidelinesDepartment of Health Research, India Technical Resource Centre
6 · The paper itself

Abstract

backgroundCommunity-acquired pneumonia (CAP) is defined as an infection of the pulmonary parenchyma acquired in the community and outside the hospital setting. CAP is generally diagnosed based on clinical parameters and chest radiography, with biomarkers increasingly used to support diagnostic decisions. Our review aims to synthesise evidence on the diagnosis of bacterial CAP using clinical assessments and biomarkers and to guide evidence-based national antibiotic guidelines for bacterial CAP in India. Our primary objective is to determine the diagnostic accuracy of clinical criteria (symptoms, examination findings, or clinical scoring systems) and chest X-rays with and without serum biomarkers for detecting bacterial CAP in children and adults with presumptive signs and symptoms of pneumonia. We also aim to investigate potential sources of heterogeneity in the diagnostic accuracy of the aforementioned index tests in relation to covariates such as the healthcare settings, HIV status, malnutrition, and comorbidities.

methodsWe will perform a systematic search of electronic databases without language and geographical restriction and bibliography mining. We will only include prospective and retrospective cross-sectional and cohort studies and Randomized Control trials. We will exclude case reports, conference abstracts, reviews, and studies with a case-control design. We will also include studies that provide or allow the derivation of diagnostic accuracy data. Participants from all healthcare settings with a presumptive diagnosis of CAP will be included. The QUADAS-2 tool will be used to ascertain the methodological quality of the selected studies. We will perform analyses of data for children and adults separately. Bivariate model will be used for meta-analysis to estimate summary sensitivity and specificity wherever possible. Certainty of evidence will be assessed using the GRADE approach (Grading of Recommendations Assessment, Development, and Evaluation) for diagnostic test accuracy studies. DISCUSSION: Our review will evaluate the diagnostic accuracy of clinical criteria, with and without biomarkers, for diagnosing bacterial CAP in children and adults. This will inform antibiotic guidelines in India and similar resource-limited settings. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42024619430 and CRD42024620335.

Indexed as

BiomarkersCommunity-Acquired PneumoniaPneumonia, BacterialAdultChildCommunity-Acquired InfectionsHumansIndiaResearch DesignSensitivity and SpecificitySystematic Reviews as TopicBiomarkersBiomarkersCommunity-acquired pneumoniaC-reactive proteinCultureCXRSystematic review

Identifiers

PMID41888890
PMCPMC13141618

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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.