About: Diagnostic accuracy of C-reactive protein and procalcitonin in suspected community-acquired pneumonia adults visiting emergency department and having a systematic thoracic CT scan

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About: Diagnostic accuracy of C-reactive protein and procalcitonin in suspected community-acquired pneumonia adults visiting emergency department and having a systematic thoracic CT scan Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	Diagnostic accuracy of C-reactive protein and procalcitonin in suspected community-acquired pneumonia adults visiting emergency department and having a systematic thoracic CT scan
Creator	Claessens, Yann-Erick Ficko, Cécile Duval, Xavier Choquet, Christophe Benjoar, Mikhael Blanc, François-Xavier Chenevier-Gobeaux, Camille Hausfater, Pierre Le Bel, Josselin Ray, Patrick
topic	covid:f3d150545162ff3cc253c235011a02a91ee676cb#this
source	Medline; PMC
abstract	INTRODUCTION: Community-acquired pneumonia (CAP) requires prompt treatment, but its diagnosis is complex. Improvement of bacterial CAP diagnosis by biomarkers has been evaluated using chest X-ray infiltrate as the CAP gold standard, producing conflicting results. We analyzed the diagnostic accuracy of biomarkers in suspected CAP adults visiting emergency departments for whom CAP diagnosis was established by an adjudication committee which founded its judgment on a systematic multidetector thoracic CT scan. METHODS: In an ancillary study of a multi-center prospective study evaluating the impact of systematic thoracic CT scan on CAP diagnosis, sensitivity and specificity of C-reactive protein (CRP) and procalcitonin (PCT) were evaluated. Systematic nasopharyngeal multiplex respiratory virus PCR was performed at inclusion. An adjudication committee classified CAP diagnostic probability on a 4-level Likert scale, based on all available data. RESULTS: Two hundred patients with suspected CAP were analyzed. The adjudication committee classified 98 patients (49.0 %) as definite CAP, 8 (4.0 %) as probable, 23 (11.5 %) as possible and excluded in 71 (35.5 %, including 29 patients with pulmonary infiltrates on chest X-ray). Among patients with radiological pulmonary infiltrate, 23 % were finally classified as excluded. Viruses were identified by PCR in 29 % of patients classified as definite. Area under the curve was 0.787 [95 % confidence interval (95 % CI), 0.717 to 0.857] for CRP and 0.655 (95 % CI, 0.570 to 0.739) for PCT to detect definite CAP. CRP threshold at 50 mg/L resulted in a positive predictive value of 0.76 and a negative predictive value of 0.75. No PCT cut-off resulted in satisfactory positive or negative predictive values. CRP and PCT accuracy was not improved by exclusion of the 25 (25.5 %) definite viral CAP cases. CONCLUSIONS: For patients with suspected CAP visiting emergency departments, diagnostic accuracy of CRP and PCT are insufficient to confirm the CAP diagnosis established using a gold standard that includes thoracic CT scan. Diagnostic accuracy of these biomarkers is also insufficient to distinguish bacterial CAP from viral CAP. TRIAL REGISTRATION: ClinicalTrials.gov registry NCT01574066 (February 7, 2012) ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13054-015-1083-6) contains supplementary material, which is available to authorized users.
has issue date	2015-10-16(xsd:dateTime)
bibo:doi	10.1186/s13054-015-1083-6
bibo:pmid	26472401
has license	cc-by
sha1sum (hex)	f3d150545162ff3cc253c235011a02a91ee676cb
schema:url	https://doi.org/10.1186/s13054-015-1083-6
resource representing a document's title	Diagnostic accuracy of C-reactive protein and procalcitonin in suspected community-acquired pneumonia adults visiting emergency department and having a systematic thoracic CT scan
has PubMed Central identifier	PMC4608327
has PubMed identifier	26472401
schema:publication	Crit Care
resource representing a document's body	covid:f3d150545162ff3cc253c235011a02a91ee676cb#body_text
is http://vocab.deri.ie/void#inDataset of	https://covidontheweb.inria.fr:4443/about/id/http/ns.inria.fr/covid19/f3d150545162ff3cc253c235011a02a91ee676cb
is schema:about of	named entity 'biomarkers' named entity 'evaluated' named entity 'procalcitonin' named entity 'CT SCAN' named entity 'COMPLEX' named entity 'INFILTRATE' named entity 'THORACIC CT' named entity 'INTRODUCTION' named entity 'ITS' named entity 'EVALUATED' named entity 'CAP' covid:arg/f3d150545162ff3cc253c235011a02a91ee676cb named entity 'THORACIC CT' named entity 'GOLD STANDARD' named entity 'SUSPECTED' named entity 'EMERGENCY DEPARTMENT' named entity 'TREATMENT' named entity 'EMERGENCY' named entity 'PROTEIN ' named entity 'DIAGNOSTIC ACCURACY' named entity 'C-REACTIVE PROTEIN' named entity 'ADULTS' named entity 'DIAGNOSTIC ACCURACY' named entity 'BUT' named entity 'PRODUCING' named entity 'BIOMARKERS' named entity 'ESTABLISHED' named entity 'JUDGMENT' named entity 'ADJUDICATION COMMITTEE' named entity 'CT SCAN' named entity 'ANALYZED' named entity 'DIAGNOSIS' named entity 'SUSPECTED' named entity 'RESULTS' named entity 'PROCALCITONIN' named entity 'MULTIDETECTOR' named entity 'CHEST X-RAY' named entity 'IMPROVEMENT' named entity 'ADULTS' named entity 'COMMUNITY-ACQUIRED PNEUMONIA' named entity 'USING' named entity 'COMMUNITY-ACQUIRED PNEUMONIA' named entity 'CONFLICTING' named entity 'BACTERIAL' named entity 'PROMPT' named entity 'diagnostic accuracy' named entity 'CAP' named entity 'chest X-ray' named entity 'thoracic' named entity 'Diagnostic accuracy' named entity 'emergency department' named entity 'thoracic' named entity 'follow-up' named entity 'sputum' named entity 'CAP' named entity 'sputum culture' named entity 'study protocol' named entity 'CAP' named entity 'CRP' named entity 'lower respiratory tract infections' named entity 'CAP' named entity 'CAP' named entity 'CRB' named entity 'respiratory disorders' named entity 'CAP' named entity 'CAP' named entity 'ROC' named entity 'CAP' named entity 'CT-scan' named entity 'gold standard'

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