ArticleCureus2026
Rethinking Pneumococcal Urinary Antigen Testing in the Emergency Department: From Reflex Testing to Reasoned Use.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Pneumococcal urinary antigen testing (PUAT) is often ordered reflexively in the emergency department (ED) because it is rapid and noninvasive. However, the ED-relevant question is not whether PUAT can detect pneumococcal antigen, but whether it reliably changes what clinicians do next: initial antibiotic selection and/or early narrowing, diagnostic strategy, disposition, and ultimately patient outcomes. The accuracy of PUAT depends on the population being tested; in cohorts enriched for confirmed pneumococcal pneumonia, performance can be overestimated. In the ED, a negative PUAT cannot reliably rule out pneumococcal disease. In addition, PUAT cannot identify polymicrobial infection, and positive results can be misinterpreted without attention to clinical context (e.g., recent infection, polysaccharide vaccination, and carriage biology). Consequently, routine PUAT may become a low-yield ritual with limited decision impact. We propose redesigning PUAT around actionability: order PUAT only when a positive result would plausibly support narrowing antibiotics in a clinically appropriate context (low aspiration and limited concern for polymicrobial infection) and when reliable sputum information is unavailable. A simple "3C" framework can help shift PUAT from reflex testing to reasoned use in ED practice.
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.