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1000 Titel
  • COVID-19 assessment in family practice—A clinical decision rule based on self-rated symptoms and contact history
1000 Autor/in
  1. Schneider, Antonius |
  2. Rauscher, Katharina |
  3. Kellerer, Christina |
  4. Linde, Klaus |
  5. Kneissl, Frederike |
  6. Hapfelmeier, Alexander |
1000 Erscheinungsjahr 2021
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2021-11-25
1000 Erschienen in
1000 Quellenangabe
  • 31(1):46
1000 Copyrightjahr
  • 2021
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1038/s41533-021-00258-4 |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8617029/ |
1000 Publikationsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • 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.
1000 Sacherschließung
lokal Clinical Decision Rules [MeSH]
lokal Epidemiology
gnd 1206347392 COVID-19
lokal Female [MeSH]
lokal Article
lokal Adult [MeSH]
lokal Family Practice [MeSH]
lokal COVID-19 [MeSH]
lokal Humans [MeSH]
lokal Prospective Studies [MeSH]
lokal Respiratory signs and symptoms
lokal SARS-CoV-2 [MeSH]
1000 Liste der Beteiligten
  1. https://orcid.org/0000-0002-2847-8626|https://frl.publisso.de/adhoc/uri/UmF1c2NoZXIsIEthdGhhcmluYQ==|https://orcid.org/0000-0002-0670-6392|https://frl.publisso.de/adhoc/uri/TGluZGUsIEtsYXVz|https://frl.publisso.de/adhoc/uri/S25laXNzbCwgRnJlZGVyaWtl|https://frl.publisso.de/adhoc/uri/SGFwZmVsbWVpZXIsIEFsZXhhbmRlcg==
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1000 Erstellt am 2023-04-26T14:31:37.632+0200
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1000 Zuletzt bearbeitet Thu Oct 19 12:44:03 CEST 2023
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