Performance of a bedside c-reactive protein test in the diagnosis of community-acquired pneumonia in adults with acute cough

Flanders, Scott A.; Stein, John C.; Shochat, Guy; Sellers, Karen; Holland, M. D. John; Maselli, Judith; Drew, W. Lawrence; Reingold, Art; Gonzales, Ralph

doi:10.1016/j.amjmed.2003.11.023

Cited by 127 publications

(111 citation statements)

References 25 publications

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“…Characteristics of the 10 excluded studies are summarized in Appendix 4, available at www.cmaj.ca/lookup/suppl/ doi:10.1503/cmaj.151163/-/DC1.) The authors of the remaining 8 studies [7][8][9]21,22,[28][29][30] provided their individual patient data, which were included in our individual patient data meta-analysis.…”

Section: Literature Search and Study Characteristicsmentioning

confidence: 99%

The added value of C-reactive protein measurement in diagnosing pneumonia in primary care: a meta-analysis of individual patient data

Minnaard

Groot

Hopstaken³

et al. 2016

CMAJ

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Section: Literature Search and Study Characteristicsmentioning

confidence: 99%

The added value of C-reactive protein measurement in diagnosing pneumonia in primary care: a meta-analysis of individual patient data

Minnaard

Groot

Hopstaken³

et al. 2016

CMAJ

Self Cite

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“…Improving diagnostic certainty may help identify those patients that will benefit from antibiotic treatment [16][17][18]. A meta-analysis that looked at 13 studies of upper respiratory tract infection (URI) and lower respiratory tract infection (LRTI) on the association between point-of-care (POC) C-reactive protein (CRP) testing and antibiotic prescribing for ARTIs in general practice found that CRP testing significantly decreased antibiotic prescribing at the initial consultation [19].…”

Section: Introductionmentioning

confidence: 99%

FebriDx Point-of-Care Testing to Guide Antibiotic Therapy for AcuteRespiratory Tract Infection in UK Primary Care: A Retrospective OutcomeAnalysis

Davidson¹

2017

J Infect Dis Preve Med

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“…8 Although CRP level in patients with LRTI appear to strongly influence the likelihood of antibiotic prescribing, 7 there remains mixed evidence about the diagnostic value of CRP in distinguishing bacterial from viral infection (aetiology), and its prognostic value in indicating potential benefit from antibiotics. [9][10][11][12][13][14] More evidence is needed about whether CRP is an effective diagnostic and prognostic tool in primary care.…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of point-of-care C-reactive protein testing to inform antibiotic prescribing decisions

Oppong¹,

Jit²,

Smith³

et al. 2013

Br J Gen Pract

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BackgroundPoint-of-care C-reactive protein (POCCRP) is a biomarker of inflammation that offers clinicians a rapid POC test to guide antibiotic prescribing decisions for acute cough and lower respiratory tract infections (LRTI). However, evidence that POCCRP is cost-effective is limited, particularly outside experimental settings. AimTo assess the cost-effectiveness of POCCRP as a diagnostic tool for acute cough and LRTI from the perspective of the health service. Design and settingObservational study of the presentation, management, and outcomes of patients with acute cough and LRTI in primary care settings in Norway and Sweden. MethodUsing hierarchical regression, data were analysed in terms of the effect on antibiotic use, cost, and patient outcomes (symptom severity after 7 and 14 days, time to recovery, and EQ-5D), while controlling for patient characteristics (self-reported symptom severity, comorbidities, and health-related quality of life) at first attendance. ResultsPOCCRP testing is associated with nonsignificant positive reductions in antibiotic prescribing (P = 0.078) and increased cost (P = 0.092). Despite the uncertainty, POCCRP testing is also associated with a cost per quality-adjusted life year (QALY) gain of €9391. At a willingness-to-pay threshold of €30 000 per QALY gained, there is a 70% probability of CRP being cost-effective. ConclusionPOCCRP testing is likely to provide a costeffective diagnostic intervention both in terms of reducing antibiotic prescribing and in terms of QALYs gained.

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Performance of a bedside c-reactive protein test in the diagnosis of community-acquired pneumonia in adults with acute cough

Cited by 127 publications

References 25 publications

The added value of C-reactive protein measurement in diagnosing pneumonia in primary care: a meta-analysis of individual patient data

The added value of C-reactive protein measurement in diagnosing pneumonia in primary care: a meta-analysis of individual patient data

FebriDx Point-of-Care Testing to Guide Antibiotic Therapy for AcuteRespiratory Tract Infection in UK Primary Care: A Retrospective OutcomeAnalysis

Cost-effectiveness of point-of-care C-reactive protein testing to inform antibiotic prescribing decisions

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