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<script type="text/javascript" src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.boots.min.js"> </script><title>Evidence review for rapid tests to inform triage and antibiotic prescribing decisions - NCBI Bookshelf</title>
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<meta name="author" content="Katie Scandrett, Jill Colquitt, Rachel Court, Fiona Whiter, Bethany Shinkins, Yemisi Takwoingi, Emma Loveman, Daniel Todkill, Paramjit Gill, Daniel Lasserson, Lena Alkhudiary, Amy Grove, Yen-Fu Chen">
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<meta name="citation_publisher" content="National Institute for Health and Care Excellence (NICE)">
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<meta name="citation_date" content="2023/10">
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<meta name="citation_author" content="Katie Scandrett">
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<meta name="citation_author" content="Jill Colquitt">
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<meta name="citation_author" content="Rachel Court">
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<meta name="citation_author" content="Fiona Whiter">
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<meta name="citation_author" content="Bethany Shinkins">
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<meta name="citation_author" content="Yemisi Takwoingi">
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<meta name="citation_author" content="Emma Loveman">
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<meta name="citation_author" content="Daniel Todkill">
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<meta name="citation_author" content="Paramjit Gill">
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<meta name="citation_author" content="Daniel Lasserson">
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<meta name="citation_author" content="Lena Alkhudiary">
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<meta name="citation_author" content="Amy Grove">
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<meta name="citation_keywords" content="Respiratory Tract Infections">
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<meta name="citation_keywords" content="Symptom Assessment">
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<meta name="citation_keywords" content="Anti-Bacterial Agents">
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<meta name="citation_keywords" content="Triage">
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<meta name="citation_keywords" content="Point-of-Care Testing">
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<meta name="citation_keywords" content="Rapid Diagnostic Tests">
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<meta name="citation_keywords" content="Treatment Outcome">
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<meta name="citation_keywords" content="biomarkers">
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<meta name="citation_keywords" content="anti-bacterial agents">
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<meta name="citation_keywords" content="triage">
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<meta name="citation_keywords" content="respiratory">
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<meta name="citation_keywords" content="infection">
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<meta name="citation_keywords" content="economic evaluation">
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<meta name="citation_keywords" content="cost utility">
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<meta name="citation_keywords" content="clinical effectiveness">
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<meta name="DC.Contributor" content="Katie Scandrett">
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<meta name="DC.Contributor" content="Jill Colquitt">
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<meta name="DC.Contributor" content="Rachel Court">
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<meta name="DC.Contributor" content="Emma Loveman">
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<meta name="DC.Contributor" content="Daniel Todkill">
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<meta name="DC.Contributor" content="Paramjit Gill">
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<meta name="DC.Contributor" content="Daniel Lasserson">
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<meta name="DC.Contributor" content="Lena Alkhudiary">
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<meta name="DC.Contributor" content="Amy Grove">
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<meta name="DC.Contributor" content="Yen-Fu Chen">
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<meta name="description" content="This review assessed the clinical- and cost-effectiveness of point of care tests (POCTs) to guide the triage and treatment of people (≥16 years old) presenting with suspected acute respiratory infection (ARI).">
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decisions" /></a></div><div class="bkr_bib"><h1 id="_NBK598986_"><span itemprop="name">Evidence review for rapid tests to inform triage and antibiotic prescribing decisions</span></h1><div class="subtitle">Suspected acute respiratory infection in over 16s: assessment at first presentation and initial management</div><p><b>Evidence review B</b></p><p><i>NICE Guideline, No. 237</i></p><p class="contrib-group"><h4>Authors</h4><span itemprop="author">Katie Scandrett</span>,<sup>1</sup> <span itemprop="author">Jill Colquitt</span>,<sup>2</sup> <span itemprop="author">Rachel Court</span>,<sup>3</sup> <span itemprop="author">Fiona Whiter</span>,<sup>4</sup> <span itemprop="author">Bethany Shinkins</span>,<sup>3</sup> <span itemprop="author">Yemisi Takwoingi</span>,<sup>1</sup> <span itemprop="author">Emma Loveman</span>,<sup>2</sup> <span itemprop="author">Daniel Todkill</span>,<sup>3</sup> <span itemprop="author">Paramjit Gill</span>,<sup>5</sup> <span itemprop="author">Daniel Lasserson</span>,<sup>5</sup> <span itemprop="author">Lena Alkhudiary</span>,<sup>3</sup> <span itemprop="author">Amy Grove</span>,<sup>3</sup> and <span itemprop="author">Yen-Fu Chen</span><sup>3</sup><sup>,<a href="#niceng237er2.fn1">*</a></sup>.</p><h4>Affiliations</h4><div class="affiliation"><sup>1</sup> Institute of Applied Health Research, University of Birmingham, Birmingham, UK</div><div class="affiliation"><sup>2</sup> Effective Evidence LLP, Waterlooville, UK</div><div class="affiliation"><sup>3</sup> Warwick Evidence, Warwick Medical School, University of Warwick, Coventry, UK</div><div class="affiliation"><sup>4</sup> Freelance reviewer</div><div class="affiliation"><sup>5</sup> Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK</div><div class="half_rhythm">London: <a href="https://www.nice.org.uk" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">National Institute for Health and Care Excellence (NICE)</span></a>; <span itemprop="datePublished">2023 Oct</span>.</div><div><a href="/books/about/copyright/">Copyright</a> © 2023 Scandrett et al. This work was produced by Scandrett et al. (West Midlands Evidence Synthesis Group) under the terms of a commissioning contract issued by the Secretary of State for Health and Social Care and has been submitted for publication in the NIHR Journals Library.</div></div><div class="bkr_clear"></div></div><div class="bkr_bottom_sep bkr_bottom_margin body-content whole_rhythm"><div itemprop="description"><h2>Abstract</h2><div id="niceng237er2_background"><h4 class="inline">Background:</h4><p>This review assessed the clinical- and cost-effectiveness of point of care tests (POCTs) to guide the triage and treatment of people (≥16 years old) presenting with suspected acute respiratory infection (ARI).</p></div><div id="niceng237er2_methods"><h4 class="inline">Methods:</h4><p>Searches for systematic reviews, RCTs and cost utility studies were conducted in May 2023. Sources included MEDLINE, Epistemonikos Embase, Cochrane CENTRAL, the CEA Registry and reference checking.</p><p>Eligible studies included people aged 16 and over making initial contact with the health system with symptoms suggestive of ARI.</p><p>Risk of bias of RCTs was assessed using the Cochrane RoB tool. The Drummond checklist was used for cost utility studies.</p><p>Meta-analyses of clinical effectiveness outcomes were conducted to estimate summary risk ratios with 95% confidence intervals.</p><p>The study characteristics and main results of included cost utility studies were summarised narratively and tabulated.</p></div><div id="niceng237er2_results"><h4 class="inline">Results:</h4><p>
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<i>Clinical effectiveness</i>
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</p><p>Fourteen studies were included; all were at a high risk of bias. Ten studies analysed POC C-reactive protein (CRP) tests. The effects of CRP tests compared with usual care on hospital admissions and mortality were highly uncertain due to sparse data. Three studies had heterogeneous findings on resolution of symptoms/time to full recovery. The risk of re-consultations increased in patients receiving CRP POCT (risk ratio 1.61, 95% CI 1.07 to 2.41; 4 studies). There was a reduction in antibiotics initially prescribed (CRP POCT vs. usual care: risk ratio 0.75, 95% CI 0.68 to 0.84; 9 studies).</p><p>The effects of procalcitonin POCT compared with usual care on hospital admission, escalation of care, and duration of symptoms were very uncertain as evidence was available from only one study. The study found a large reduction in initial antibiotic prescriptions within 7 days.</p><p>Two studies found a large reduction in initial antibiotic prescriptions for Group A Streptococcus (GAS) POCTs versus usual care. Only one study compared an influenza POCT with usual care. The effect on antibiotics prescribed was very uncertain. No deaths occurred in either treatment group.</p><p>
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<i>Cost-effectiveness</i>
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</p><p>Six of the included cost utility studies were judged to be directly applicable to our review question, four of which evaluated the cost-effectiveness of CRP POCT. The results suggested that CRP POCT is potentially cost-effective; these studies were generally limited to capturing only short-term costs and consequences.</p><p>One cost utility study evaluated 14 different POCTs for GAS and found that none of the POCTs evaluated were cost-effective compared with usual care.</p><p>A further study evaluated two rapid tests (Quidel for influenza, and BinaxNOW for the pneumococcal antigen) compared to culture/serology and found that they were not cost-effective.</p></div><div id="niceng237er2_funding"><h4 class="inline">Funding:</h4><p>This project was funded by NIHR Evidence Synthesis Programme, Project number NIHR159946.</p></div><div id="niceng237er2_registration"><h4 class="inline">Registration:</h4><p>PROSPERO CRD42023429515</p></div><div id="niceng237er2_plain_language_summary"><h4 class="inline">Plain Language Summary:</h4><p>Acute respiratory infection is a group of common diseases caused by viruses or bacteria. Examples of acute respiratory infection include ‘cold’ and flu. When people consult a doctor (or other healthcare professionals) for suspected acute respiratory infection, it is not always easy for the doctor to identify what is causing the symptoms. The doctor also needs to assess whether the patient’s condition is serious or may become serious. Laboratory tests can provide useful information to help the doctor decide what to do next, but it used to take several hours or days to get the test results back. This delay means the doctor cannot use the test results to make a decision while seeing the patient. Rapid tests that can be done and produce results quickly (within 45 minutes) are now available. It is currently unclear whether the use of these rapid tests to assess patients would improve or worsen patient outcomes or increase or decrease costs overall.</p><p>We conducted a rapid review of the literature to summarise the best available published evidence to help answer these questions. We found that rapid tests for C-reactive protein (a substance that tends to increase more in our blood when we have an infection caused by bacteria) may reduce the need for doctors to prescribe antibiotics, but the number of patients who come back to see the doctor again may increase. There is still some uncertainty in this evidence. Previous studies suggested that the test may represent good value for money but most studies only considered costs and outcomes in the short-term. Evidence is either very limited to draw conclusions or did not indicate good value for money for other rapid tests that we evaluated.</p></div></div></div><div id="niceng237er2.abb"><h2 id="_niceng237er2_abb_">List of abbreviations</h2><dl><dt id="niceng237er2.abb_DL1_DI1">AMR</dt><dd><p>Antimicrobial resistance</p></dd><dt id="niceng237er2.abb_DL1_DI2">ARI</dt><dd><p>Acute respiratory infection</p></dd><dt id="niceng237er2.abb_DL1_DI3">CEAC</dt><dd><p>Cost-effectiveness acceptability curve</p></dd><dt id="niceng237er2.abb_DL1_DI4">COPD</dt><dd><p>Chronic obstructive pulmonary disease</p></dd><dt id="niceng237er2.abb_DL1_DI5">CRP</dt><dd><p>C-reactive protein</p></dd><dt id="niceng237er2.abb_DL1_DI6">CUA</dt><dd><p>Cost-utility analysis</p></dd><dt id="niceng237er2.abb_DL1_DI7">DIA</dt><dd><p>Digital immunoassay</p></dd><dt id="niceng237er2.abb_DL1_DI8">GAS</dt><dd><p>Group A streptococcus</p></dd><dt id="niceng237er2.abb_DL1_DI9">GP</dt><dd><p>General practice / general practitioner</p></dd><dt id="niceng237er2.abb_DL1_DI10">HRQoL</dt><dd><p>Health-related quality of life</p></dd><dt id="niceng237er2.abb_DL1_DI11">ICD</dt><dd><p>International Classification of Diseases</p></dd><dt id="niceng237er2.abb_DL1_DI12">ICER</dt><dd><p>Incremental cost-effectiveness ratio</p></dd><dt id="niceng237er2.abb_DL1_DI13">ITT</dt><dd><p>Intention to treat</p></dd><dt id="niceng237er2.abb_DL1_DI14">LRTI</dt><dd><p>Lower respiratory tract infection</p></dd><dt id="niceng237er2.abb_DL1_DI15">NAAT</dt><dd><p>Nucleic acid amplification tests</p></dd><dt id="niceng237er2.abb_DL1_DI16">NAI</dt><dd><p>Neuraminidase inhibitors</p></dd><dt id="niceng237er2.abb_DL1_DI17">NMB</dt><dd><p>Net monetary benefit</p></dd><dt id="niceng237er2.abb_DL1_DI18">NR</dt><dd><p>Not reported</p></dd><dt id="niceng237er2.abb_DL1_DI19">NHS</dt><dd><p>National Health Service</p></dd><dt id="niceng237er2.abb_DL1_DI20">NICE</dt><dd><p>National Institute for Health and Care Excellence</p></dd><dt id="niceng237er2.abb_DL1_DI21">OIA</dt><dd><p>Optical immunoassay</p></dd><dt id="niceng237er2.abb_DL1_DI22">PCR</dt><dd><p>Polymerase chain reaction</p></dd><dt id="niceng237er2.abb_DL1_DI23">POC</dt><dd><p>Point of care</p></dd><dt id="niceng237er2.abb_DL1_DI24">POCT</dt><dd><p>Point of care test</p></dd><dt id="niceng237er2.abb_DL1_DI25">QALD</dt><dd><p>Quality-adjusted life day</p></dd><dt id="niceng237er2.abb_DL1_DI26">QALE</dt><dd><p>Quality-adjusted life expectancy</p></dd><dt id="niceng237er2.abb_DL1_DI27">QALY</dt><dd><p>Quality-adjusted life year</p></dd><dt id="niceng237er2.abb_DL1_DI28">RADT</dt><dd><p>Rapid antigen detection test</p></dd><dt id="niceng237er2.abb_DL1_DI29">RIDT</dt><dd><p>Rapid influenza diagnostic test</p></dd><dt id="niceng237er2.abb_DL1_DI30">RCT</dt><dd><p>Randomised controlled trial</p></dd><dt id="niceng237er2.abb_DL1_DI31">RR</dt><dd><p>Risk ratio</p></dd><dt id="niceng237er2.abb_DL1_DI32">RSV</dt><dd><p>Respiratory syncytial virus</p></dd><dt id="niceng237er2.abb_DL1_DI33">RTI</dt><dd><p>Respiratory tract infection</p></dd><dt id="niceng237er2.abb_DL1_DI34">SD</dt><dd><p>Standard deviation</p></dd><dt id="niceng237er2.abb_DL1_DI35">SE</dt><dd><p>Standard error</p></dd><dt id="niceng237er2.abb_DL1_DI36">US</dt><dd><p>United States</p></dd><dt id="niceng237er2.abb_DL1_DI37">WTP</dt><dd><p>Willingness to pay</p></dd></dl></div><div id="niceng237er2.s1"><h2 id="_niceng237er2_s1_">1. Introduction</h2><p>Acute respiratory infection (ARI) is a common illness caused by a wide variety of viral and bacterial pathogens. In the UK, self-management is encouraged for adults with suspected ARI with minor symptoms. People with more severe symptoms, or ongoing symptoms that do not resolve and worsen over time may contact NHS 111 through a designated website or telephone, seek an appointment with their general practitioner (GP), visit a walk-in centre or request a home visit (including care homes) by a GP. More recently, ARI hubs (which are treatments centres established specifically for ARI to provide new or more integrated services with same-day access in addition to the existing services mentioned above) are being set up through funding provided by NHS England.<a class="bibr" href="#niceng237er2.ref1" rid="niceng237er2.ref1"><sup>1</sup></a> Patients who are severely unwell suggestive of serious conditions and/or rapid deterioration may call the ambulance service or self-present to a hospital emergency department (ED) department. A variety of rapid point of care tests (POCTs), defined as any medical device and/or system that enables diagnosis, monitoring or screening of patients at the time and place of care by appropriately trained users,<a class="bibr" href="#niceng237er2.ref2" rid="niceng237er2.ref2"><sup>2</sup></a> have become available that could help healthcare professionals in the initial assessment of patients with suspected ARI in these settings. Evidence on clinical and cost-effectiveness of these tests is emerging and requires careful evaluation to inform a decision on their adoption in clinical practice. This rapid synthesis of evidence addresses this gap.</p><p>Two broad types of POCTs are considered:
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<dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>(1)</dt><dd><p class="no_top_margin">POCTs for determining the possible cause of the acute respiratory symptoms. These can be further categorised into two groups:
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<dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>i)</dt><dd><p class="no_top_margin">POCTs using host biomarkers to detect an inflammatory response and/or distinguish between bacterial and viral infections</p><p>These tests utilise host-response biomarkers that can be potential surrogates for detecting bacterial infections.<a class="bibr" href="#niceng237er2.ref3" rid="niceng237er2.ref3"><sup>3</sup></a> Many rapid tests targeting different biomarkers have been developed, including those for C-reactive protein (CRP)<a class="bibr" href="#niceng237er2.ref3" rid="niceng237er2.ref3"><sup>3</sup></a>, procalcitonin,<a class="bibr" href="#niceng237er2.ref4" rid="niceng237er2.ref4"><sup>4</sup></a> Myxovirus resistance protein A (MxA),<a class="bibr" href="#niceng237er2.ref5" rid="niceng237er2.ref5"><sup>5</sup></a> Tumour necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL),<a class="bibr" href="#niceng237er2.ref5" rid="niceng237er2.ref5"><sup>5</sup></a> and Interferon-γ-induced protein-10 (IP-10, also known as C-X-C motif chemokine ligand 10 [CXCL 10]).<a class="bibr" href="#niceng237er2.ref6" rid="niceng237er2.ref6"><sup>6</sup></a> Some POCTs can test more than one biomarker simultaneously.<a class="bibr" href="#niceng237er2.ref7" rid="niceng237er2.ref7"><sup>7</sup></a></p></dd></dl><dl class="bkr_refwrap"><dt>ii)</dt><dd><p class="no_top_margin">POCTs for the detection of specific pathogens</p><p>These tests detect antigens (substances such as nucleic acid or protein) from specific viruses or bacteria that may have caused the symptoms for the suspected ARI, and so are also known as rapid antigen tests. Common targets of rapid antigen tests related to ARI include influenza A and B, Respiratory syncytial virus (RSV),<a class="bibr" href="#niceng237er2.ref8" rid="niceng237er2.ref8"><sup>8</sup></a> Group A β-hemolytic Streptococcus,<a class="bibr" href="#niceng237er2.ref9" rid="niceng237er2.ref9"><sup>9</sup></a> and Streptococcus pneumoniae and Legionella pneumophila.<a class="bibr" href="#niceng237er2.ref10" rid="niceng237er2.ref10"><sup>10</sup></a></p><p>Given the relatively low cost of COVID-19 lateral flow tests and their wide adoption by the general public with suspected ARI, rapid tests for COVID-19 infection are likely to be used earlier in the diagnostic pathway compared with other POCTs for ARI, and therefore they were not evaluated in this rapid evidence synthesis.</p></dd></dl></dl></p></dd></dl><dl class="bkr_refwrap"><dt>(2)</dt><dd><p class="no_top_margin">POCTs for monitoring the patient’s physiological condition and detection of those in unstable or critical condition requiring urgent referral or immediate intervention. These tests have wide clinical applications and are not specifically used for patients with ARI. They include:
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<ul class="simple-list"><li class="half_rhythm"><div>Blood gases (arterial blood gas analysis), which may also simultaneously provide blood chemistry/electrolytes analysis, including lactate, sodium and urea. These could alternatively obtained through blood samples drawn from veins.</div></li><li class="half_rhythm"><div>Full blood count: this test assesses the number of red blood cells, white blood cells (white blood cell count) and platelets in the blood, measures the size and amount of haemoglobin in the red blood cells and calculates the haematocrit (percentage of red blood cells in terms of volume in the blood).</div></li></ul></p></dd></dl></dl></p></div><div id="niceng237er2.s2"><h2 id="_niceng237er2_s2_">2. Objectives</h2><p>The objectives of this rapid synthesis were to identify, appraise and synthesise evidence on the clinical effectiveness and cost effectiveness of different near-patient, rapid microbiological or biomarker tests alone or in combination to guide initial assessment and management in people aged 16 and over with suspected ARI.</p></div><div id="niceng237er2.s3"><h2 id="_niceng237er2_s3_">3. Methods</h2><p>This research consists of two distinct reviews, conducted in parallel, one focused on clinical effectiveness and one focused on cost-effectiveness. The methods used to conduct these reviews were pre-specified and documented in a protocol (<a href="#niceng237er2.app1">Appendix 1</a>), which was registered on Prospero (reference: CRD42023429515). There is synergy between the two methodologies presented. In this section, we first describe the methodology for the clinical effectiveness review. We then detail the methodology for the cost-effectiveness review, highlighting where the methodology differs (to avoid repetition).</p><div id="niceng237er2.s3.1"><h3>3.1. Clinical Effectiveness Review</h3><div id="niceng237er2.s3.1.1"><h4>3.1.1. Search Strategy</h4><p>Searches were developed iteratively and combined the concepts of acute respiratory infections and near patient and rapid tests, with study type filters being applied where appropriate.</p><div id="niceng237er2.s3.1.1.1"><h5>3.1.1.1. Systematic reviews</h5><p>The following databases were searched from inception to May 2023 (see <a href="#niceng237er2.app2">Appendix 2</a> for exact dates) for systematic reviews:
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<ul><li class="half_rhythm"><div>MEDLINE via Ovid</div></li><li class="half_rhythm"><div>Epistemonikos</div></li></ul></p><p>Search concepts combined acute respiratory infection and rapid tests (as a broad concept). These elements were based on the draft search strategy developed by Bristol Evidence Synthesis Group for a related review, with some terms removed (see excluded conditions listed in <a href="#niceng237er2.s3.1.2.1">section 3.1.2.1</a> below). <a href="#niceng237er2.app2">Appendix 2</a> shows our full record of searches. A sensitive systematic review search filter (based on CADTH’s SR / MA / HTA / ITC filter<a class="bibr" href="#niceng237er2.ref11" rid="niceng237er2.ref11"><sup>11</sup></a>) was applied to the MEDLINE search. No date limit was applied. The MEDLINE search was restricted to English language, and comments, editorials, letters and news items were removed.</p><p>References identified by the project team via highly targeted searches during the scoping phase were also reviewed.</p></div><div id="niceng237er2.s3.1.1.2"><h5>3.1.1.2. RCTs</h5><p>Additional searches to find RCTs were conducted in the following databases.</p><ul><li class="half_rhythm"><div>Cochrane Central Register of Controlled Trials (CENTRAL), from inception</div></li><li class="half_rhythm"><div>Embase (Ovid), limited by date</div></li><li class="half_rhythm"><div>MEDLINE (Ovid), limited by date</div></li></ul><p>The same subject search terms to those used for the search for systematic reviews were included, but we broadened this search by adding terms for specific biomarkers and tests in combination with terms for guide or inform. These terms were included in order to additionally capture the concept of biomarker test guided management. See <a href="#niceng237er2.app2">Appendix 2</a> for our full record of searches. As the identified systematic reviews were all limited to specific populations, interventions and outcomes (that is, none fully addressed our research question), and it was difficult to say whether a combination of reviews would cover our review question, we did not to limit the CENTRAL search by date. Based on an understanding of how the CENTRAL database is created<a class="bibr" href="#niceng237er2.ref12" rid="niceng237er2.ref12"><sup>12</sup></a> and the rapid timescales for this review, we searched MEDLINE and Embase for literature published from 2022 to May 2023 only by applying a date limit. A sensitive RCT filter was used in MEDLINE and Embase (based on the latest versions of Cochrane’s sensitivity- and precision-maximizing versions<a class="bibr" href="#niceng237er2.ref13" rid="niceng237er2.ref13"><sup>13</sup></a><sup>–</sup><a class="bibr" href="#niceng237er2.ref15" rid="niceng237er2.ref15"><sup>15</sup></a>).</p><p>Searches were restricted to English language and humans, and excluded:
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<ul><li class="half_rhythm"><div>Conference abstracts</div></li><li class="half_rhythm"><div>Editorials, letters, news items and commentaries</div></li></ul></p><p>Pre-print sources were not searched.</p><p>References of included studies and relevant systematic reviews were checked.</p></div></div><div id="niceng237er2.s3.1.2"><h4>3.1.2. Inclusion and Exclusion Criteria</h4><div id="niceng237er2.s3.1.2.1"><h5>3.1.2.1. Population</h5><div id="niceng237er2.s3.1.2.1.1"><h5>Inclusion criteria</h5><p>People aged 16 years or over with suspected acute respiratory infection.</p></div><div id="niceng237er2.s3.1.2.1.2"><h5>Exclusion criteria</h5><p>People aged 16 years or over:
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<ul><li class="half_rhythm"><div>With a confirmed COVID-19 diagnosis (patients with known COVID will be triaged in a different way, suspected COVID would be treated as suspected ARI).</div></li><li class="half_rhythm"><div>All inpatients in hospital.</div></li><li class="half_rhythm"><div>Who have a respiratory infection during end-of-life care.</div></li><li class="half_rhythm"><div>With aspiration pneumonia, bronchiectasis, cystic fibrosis or known immunosuppression.</div></li><li class="half_rhythm"><div>Who are presenting with acute respiratory infections that rarely require or lead to escalation of care to hospital admission such as otitis media and sinusitis.</div></li></ul></p><p>Children and young people under 16 years were excluded. Acute respiratory infection mostly found in children and infants such as croup, bronchiolitis and whooping cough are therefore excluded.</p></div></div><div id="niceng237er2.s3.1.2.2"><h5>3.1.2.2. Intervention</h5><div id="niceng237er2.s3.1.2.2.1"><h5>Inclusion criteria</h5><p>Near patient, rapid tests (turnaround time ≤ 45mins, also known as point of care tests) which are currently licensed and available for use in the UK as follows:
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<ul><li class="half_rhythm"><div>Rapid antigen test</div></li><li class="half_rhythm"><div>Rapid PCR tests</div></li><li class="half_rhythm"><div>Urinary antigen tests</div></li><li class="half_rhythm"><div>C-reactive protein</div></li><li class="half_rhythm"><div>Procalcitonin</div></li><li class="half_rhythm"><div>Serum sodium</div></li><li class="half_rhythm"><div>Urea nitrogen</div></li><li class="half_rhythm"><div>Partial pressure O<sub>2</sub></div></li><li class="half_rhythm"><div>Blood gases</div></li><li class="half_rhythm"><div>Full blood count</div></li><li class="half_rhythm"><div>White blood cell count</div></li><li class="half_rhythm"><div>Myxovirus resistance protein A</div></li><li class="half_rhythm"><div>TNF-related apoptosis-induced ligand (TRAIL)</div></li><li class="half_rhythm"><div>Interferon-γ-induced protein-10 (IP-10)</div></li></ul></p><p>Protocol amendment: where a test is no longer available in the UK and it was unclear whether it has been superseded by a similar version or product, and the study was otherwise eligible, a pragmatic decision was made to include the study with a caveat regarding test availability.</p></div><div id="niceng237er2.s3.1.2.2.2"><h5>Exclusion criterion</h5><p>Tests for Covid-19</p></div></div><div id="niceng237er2.s3.1.2.3"><h5>3.1.2.3. Comparator</h5><p>Current practice</p></div><div id="niceng237er2.s3.1.2.4"><h5>3.1.2.4. Outcomes</h5><ul><li class="half_rhythm"><div>Hospital admission (immediately after triage or at 28 days)</div></li><li class="half_rhythm"><div>Escalation of care (some time after initial consultation):
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<dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>-</dt><dd><p class="no_top_margin">Re-consultation/appointment</p></dd></dl><dl class="bkr_refwrap"><dt>-</dt><dd><p class="no_top_margin">Virtual Ward</p></dd></dl><dl class="bkr_refwrap"><dt>-</dt><dd><p class="no_top_margin">Emergency department visit</p></dd></dl><dl class="bkr_refwrap"><dt>-</dt><dd><p class="no_top_margin">Unplanned hospital admission</p></dd></dl></dl></div></li><li class="half_rhythm"><div>Hospital length of stay</div></li><li class="half_rhythm"><div>Follow-up consultation/ongoing monitoring</div></li><li class="half_rhythm"><div>Antibiotic/antiviral use</div></li><li class="half_rhythm"><div>Time to clinical cure/resolution of symptoms</div></li><li class="half_rhythm"><div>Mortality</div></li><li class="half_rhythm"><div>HRQoL (using a validated scale)</div></li></ul></div><div id="niceng237er2.s3.1.2.5"><h5>3.1.2.5. Study designs</h5><div id="niceng237er2.s3.1.2.5.1"><h5>Inclusion criteria</h5><ul><li class="half_rhythm"><div>Systematic reviews of RCTs</div></li><li class="half_rhythm"><div>RCTs</div></li></ul></div><div id="niceng237er2.s3.1.2.5.2"><h5>Exclusion criteria</h5><ul><li class="half_rhythm"><div>Non-systematic reviews</div></li><li class="half_rhythm"><div>Non RCTs</div></li><li class="half_rhythm"><div>Studies not published in English</div></li><li class="half_rhythm"><div>Pre-prints</div></li><li class="half_rhythm"><div>Dissertations and theses</div></li><li class="half_rhythm"><div>Registry entries for ongoing clinical trials</div></li><li class="half_rhythm"><div>Editorials, letters, news items and commentaries</div></li><li class="half_rhythm"><div>Animal studies</div></li><li class="half_rhythm"><div>Conference abstracts and posters</div></li><li class="half_rhythm"><div>Derivation studies</div></li></ul></div></div></div><div id="niceng237er2.s3.1.3"><h4>3.1.3. Screening</h4><p>Titles and abstracts were reviewed by one reviewer with 20% of the titles and abstracts being reviewed by two reviewers (FW, JC). We aimed to achieve at least 90% agreement before proceeding to single reviewer screening. Any disagreements were resolved by discussion or, if necessary, a third independent reviewer (EL).</p><p>The full text of potentially eligible studies were retrieved and assessed in line with the criteria outlined above by one reviewer (FW, JC or EL). The initial 20% of potentially eligible studies were assessed by two reviewers (FW, JC or EL). At least 90% agreement was achieved before proceeding with single reviewer screening.</p><p>Disagreements between reviewers were resolved by discussion, with involvement of a third review author where necessary.</p></div><div id="niceng237er2.s3.1.4"><h4>3.1.4. Assessment of identified systematic reviews</h4><p>Identified systematic reviews were considered for the rapid review both as the primary source of evidence and as a source of RCTs.</p><p>Starting with the most recent published reviews, identified systematic reviews were assessed for their applicability, and those eligible were quality assessed using published tools (see Risk of Bias <a href="#niceng237er2.s3.1.6">section 3.1.6</a>). Systematic reviews of good quality that closely match the review protocol were extracted rather than extracting from the primary studies. Where a good quality review was found, earlier reviews with largely overlapping scope and RCTs covered by the review were not assessed or extracted.</p><p>As no good quality, applicable systematic reviews were identified for all interventions, and because there were evidence gaps (for example missing interventions or outcomes) in the systematic reviews, we conducted searches for RCTs following the methods described above.</p><p>All references identified by the searches and from other sources were uploaded into Endnote and de-duplicated.</p></div><div id="niceng237er2.s3.1.5"><h4>3.1.5. Data extraction</h4><p>A pre-piloted and standardised form was used to extract data from studies. All extractions were checked by a second reviewer.</p><p>Disagreements between reviewers were resolved by discussion, with involvement of a third review author where necessary.</p></div><div id="niceng237er2.s3.1.6"><h4>3.1.6. Risk of bias assessment</h4><p>The quality of included systematic reviews and RCTs were assessed by one reviewer, with the initial 20% assessed by a second reviewer to ensure that consistency was achieved. For systematic reviews we used the tool produced by the Joanna Briggs Institute (<a href="https://jbi.global/critical-appraisal-tools" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://jbi.global/critical-appraisal-tools</a>); for RCTs we used the Cochrane RoB tool consistent with the identified systematic reviews. Risk of bias was assessed for each trial and for individual outcomes of importance to the review question; a summary of the risk of bias assessment is presented by the type of intervention. For RCTs included in the Smedemark 2022 Cochrane review,<a class="bibr" href="#niceng237er2.ref16" rid="niceng237er2.ref16"><sup>16</sup></a> we used the judgements by the Cochrane review authors for study level bias and conducted new assessments for outcomes relevant to the present review.</p><p>We assessed the certainty of the evidence using the GRADE assessment (risk of bias, indirectness, inconsistency, imprecision and publication bias) for the key outcomes of:
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<ul><li class="half_rhythm"><div>7- or 28-day mortality</div></li><li class="half_rhythm"><div>escalation of care (including unplanned admission)</div></li><li class="half_rhythm"><div>hospital admission (immediately after triage or at 28 days)</div></li></ul></p><p>One reviewer undertook the GRADE assessment, and this was checked by a second reviewer.</p></div><div id="niceng237er2.s3.1.7"><h4>3.1.7. Evidence Synthesis</h4><p>All included RCTs were tabulated and summarised narratively.</p><p>Meta-analysis of clinical effectiveness outcomes was performed when sufficient data from reasonably homogeneous studies were available. This was guided by study design, population, outcomes, and risk of bias assessment. A sample size adjustment was made to cluster randomised trials before they were included in a meta-analysis or forest plot with individually randomised trials. We followed methods in the Cochrane Handbook for Systematic Reviews of Interventions for calculating the effective sample size.<a class="bibr" href="#niceng237er2.ref17" rid="niceng237er2.ref17"><sup>17</sup></a> The adjustment was done by dividing the total numbers in each arm and the event numbers in each arm by the ‘design effect’. The design effect for each cluster randomised trial was calculated using the formula:
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<div class="pmc_disp_formula whole_rhythm clearfix" id="niceng237er2.deq1"><div class="inline_block pmc_inline_block pmc_va_middle pmc_hide_overflow twelve_col"><math id="niceng237er2.eq1" display="block"><mrow><mn>1</mn><mo>+</mo><mo stretchy="false">(</mo><mtext>M</mtext><mo>−</mo><mn>1</mn><mo stretchy="false">)</mo><mo>×</mo><mtext>ICC</mtext></mrow></math></div><div class="inline_block pmc_inline_block pmc_va_middle pmc_hide_overflow last bk_equ_label "><div><span class="nowrap"></span></div></div></div>
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where M is the average cluster size and ICC is the intracluster correlation coefficient.</p><p>Random effects models were fitted using the DerSimonian and Laird method in the metan command in Stata version 17. Alternative methods for performing random-effects meta-analyses were explored because no single approach is universally preferable.<a class="bibr" href="#niceng237er2.ref18" rid="niceng237er2.ref18"><sup>18</sup></a> Inconsistency across studies was assessed using the I<sup>2</sup> statistic. Due to insufficient number of studies (<10) in each meta-analysis, funnel plots were not constructed to assess small study effects. We did not attempt to contact authors to get pertinent missing data due to a lack of time.</p></div><div id="niceng237er2.s3.1.8"><h4>3.1.8. Analysis of sub-groups</h4><p>We pre-specified that stratified data for the following subgroups were to be considered for subgroup analyses irrespective of statistical heterogeneity:
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<ul><li class="half_rhythm"><div>Age of patient (65 years and under, 66 – 80 years, over 80 years)</div></li><li class="half_rhythm"><div>Presence of chronic co-morbidity (for example, COPD)</div></li><li class="half_rhythm"><div>Pregnancy & post-partum (up to 28 days)</div></li></ul></p><p>Only data stratified by the presence or absence of COPD were available among included studies.</p></div><div id="niceng237er2.s3.1.9"><h4>3.1.9. Sensitivity analyses</h4><p>Sensitivity analyses were undertaken to explore the impact of co-morbidity, setting and test availability on the main analyses.</p></div></div><div id="niceng237er2.s3.2"><h3>3.2. Cost Effectiveness Review</h3><div id="niceng237er2.s3.2.1"><h4>3.2.1. Search Strategy</h4><p>Searches combined the concepts of: a) acute respiratory infections, b) near patient, rapid tests (or, more broadly, diagnostics and testing), and c) cost utility.</p><p>Searches for cost utility studies were conducted in the following databases in May 2023:
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<ul><li class="half_rhythm"><div>MEDLINE (Ovid), from inception</div></li><li class="half_rhythm"><div>Embase (Ovid), from inception</div></li><li class="half_rhythm"><div>CEA registry, from inception</div></li></ul></p><p>A precise, yet highly sensitive cost utility study filter was used in Embase and Medline.<a class="bibr" href="#niceng237er2.ref19" rid="niceng237er2.ref19"><sup>19</sup></a> See <a href="#niceng237er2.app2">Appendix 2</a> for our full record of searches. Our search was developed iteratively in MEDLINE. The final version finds a known systematic review,<a class="bibr" href="#niceng237er2.ref20" rid="niceng237er2.ref20"><sup>20</sup></a> and 13 studies included in it that were likely to be relevant to our research question. No date limit was applied.</p><p>References identified by the project team via highly targeted searches during the scoping phase were also reviewed.</p><p>Searches were restricted to English language and humans, and excluded:
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<ul><li class="half_rhythm"><div>Dissertations and theses</div></li><li class="half_rhythm"><div>Conference abstracts</div></li><li class="half_rhythm"><div>Editorials, letters, news items and commentaries</div></li></ul></p><p>Pre-print sources were not searched.</p><p>References of included studies and relevant systematic reviews were checked.</p></div><div id="niceng237er2.s3.2.2"><h4>3.2.2. Inclusion and Exclusion Criteria</h4><p>The inclusion and exclusion criteria for the cost-effectiveness review were the same as the clinical-effectiveness review in terms of the population, intervention, and comparator eligible (see <a href="#niceng237er2.s3.1.2">section 3.1.2</a>). The exclusion criteria in terms of study design were also the same. The inclusion criteria for relevant outcomes and study designs differed and are described here.</p><div id="niceng237er2.s3.2.2.1"><h5>3.2.2.1. Outcomes</h5><div id="niceng237er2.s3.2.2.1.1"><h5>Inclusion criteria</h5><ul><li class="half_rhythm"><div>Incremental cost (NHS and personal social services perspective)</div></li><li class="half_rhythm"><div>Life-years gained</div></li><li class="half_rhythm"><div>Incremental QALYs</div></li><li class="half_rhythm"><div>Incremental DALYS</div></li><li class="half_rhythm"><div>ICER/ cost per QALY</div></li><li class="half_rhythm"><div>Incremental net health/monetary benefit</div></li></ul></div></div><div id="niceng237er2.s3.2.2.2"><h5>3.2.2.2. Study Designs</h5><div id="niceng237er2.s3.2.2.2.1"><h5>Inclusion criteria</h5><ul><li class="half_rhythm"><div>Systematic reviews of economic evaluations</div></li><li class="half_rhythm"><div>Economic evaluations which included a cost utility study</div></li></ul></div></div></div><div id="niceng237er2.s3.2.3"><h4>3.2.3. Screening</h4><p>Initial screening of titles and abstracts, followed by full text screening was carried out using Rayyan <a href="https://www.rayyan.ai/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www.rayyan.ai/</a>).<a class="bibr" href="#niceng237er2.ref21" rid="niceng237er2.ref21"><sup>21</sup></a> All records at both phases of screening were assessed by two independent reviewers (BS and KS), blinded to each other’s decisions. Any conflicting screening decisions were resolved through discussion, with a third independent reviewer (YFC) if needed.</p></div><div id="niceng237er2.s3.2.4"><h4>3.2.4. Data extraction</h4></div><div id="niceng237er2.s3.2.5"><h4>3.2.5. Applicability and Critical Appraisal</h4><p>For systematic reviews of cost-effectiveness studies, we used the tool produced by the Joanna Briggs Institute (<a href="https://jbi.global/critical-appraisal-tools" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://jbi.global/critical-appraisal-tools</a>) to assess the quality of the review. We then provide a narrative description of their applicability to our review question.</p><p>To assess the quality of included cost utility studies, we used the Drummond checklist.<a class="bibr" href="#niceng237er2.ref22" rid="niceng237er2.ref22"><sup>22</sup></a> We also used <a href="#niceng237er2.s1">Section 1</a> of the NICE appraisal checklist for economic evaluations to assess the applicability of each study to our review question.<a class="bibr" href="#niceng237er2.ref23" rid="niceng237er2.ref23"><sup>23</sup></a> This was done by one reviewer (KS), and then checked by a second reviewer (BS).</p></div><div id="niceng237er2.s3.2.6"><h4>3.2.6. Evidence Synthesis</h4><p>All included systematic reviews and cost utility studies were tabulated and summarised narratively.</p></div></div></div><div id="niceng237er2.s4"><h2 id="_niceng237er2_s4_">4. Results</h2><div id="niceng237er2.s4.1"><h3>4.1. Clinical effectiveness review results</h3><div id="niceng237er2.s4.1.1"><h4>4.1.1. Results of the search</h4><div id="niceng237er2.s4.1.1.1"><h5>4.1.1.1. Systematic reviews</h5><p>A systematic search carried out to identify potentially relevant systematic reviews found 1355 references (see <a href="#niceng237er2.app2">Appendix 2</a> for the literature search strategy).</p><p>These 1355 references were screened at title and abstract level against the review protocol, with 1292 excluded at this level. Twenty percent of references were screened separately by two reviewers with 96.6% agreement. Discrepancies were resolved by discussion. An additional seven references were identified through examining reference lists.</p><p>The full texts of 70 systematic reviews were ordered for closer inspection. Five of these systematic reviews reported synthesised evidence relevant to the review protocol; four of the earlier reviews had largely overlapping scopes and RCTs covered by the most recent review and were not quality assessed or extracted. One systematic review was included as a source of data only (<a href="#niceng237er2.s4.1.2">Sections 4.1.2</a> and <a href="#niceng237er2.s4.1.3">4.1.3</a>).</p><p>The systematic review evidence selection is presented as a PRISMA diagram in <a href="#niceng237er2.app3">Appendix 3</a>.</p><p>Details of reviews excluded at full text, along with reasons for exclusion are given in <a href="#niceng237er2.app4">Appendix 4</a>.</p></div><div id="niceng237er2.s4.1.1.2"><h5>4.1.1.2. RCTs</h5><p>A systematic search carried out to identify potentially relevant studies found 2341 references (see <a href="#niceng237er2.app2">Appendix 2</a> for the literature search strategy).</p><p>These 2341 references were screened at title and abstract level against the review protocol, with 2265 excluded at this level. 20% of references were screened separately by two reviewers with 98.8% agreement. Discrepancies were resolved by discussion. An additional 42 references were identified through examining reference lists of relevant systematic reviews.</p><p>The full texts of 118 records were ordered for closer inspection. Fourteen of these studies met the criteria specified in the review protocol.</p><p>The clinical evidence study selection is presented as a PRISMA diagram in <a href="#niceng237er2.app5">Appendix 5</a>.</p><p>See <a class="figpopup" href="/books/NBK598986/table/niceng237er2.tab1/?report=objectonly" target="object" rid-figpopup="figniceng237er2tab1" rid-ob="figobniceng237er2tab1">Table 1</a>, <a class="figpopup" href="/books/NBK598986/table/niceng237er2.tab4/?report=objectonly" target="object" rid-figpopup="figniceng237er2tab4" rid-ob="figobniceng237er2tab4">Table 4</a>, <a class="figpopup" href="/books/NBK598986/table/niceng237er2.tab5/?report=objectonly" target="object" rid-figpopup="figniceng237er2tab5" rid-ob="figobniceng237er2tab5">Table 5</a>, and <a class="figpopup" href="/books/NBK598986/table/niceng237er2.tab7/?report=objectonly" target="object" rid-figpopup="figniceng237er2tab7" rid-ob="figobniceng237er2tab7">Table 7</a> for the full references of the included studies and <a href="#niceng237er2.app6">Appendix 6</a> for the data extraction of the 14 included studies.</p><p>Details of studies excluded at full text, along with reasons for exclusion are given in <a href="#niceng237er2.app7">Appendix 7</a></p><p>No eligible evidence was identified for the following tests specified in the review protocol:
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<ul><li class="half_rhythm"><div>Rapid PCR tests</div></li><li class="half_rhythm"><div>Urinary antigen tests</div></li><li class="half_rhythm"><div>Serum sodium</div></li><li class="half_rhythm"><div>Urea nitrogen</div></li><li class="half_rhythm"><div>Partial pressure O2</div></li><li class="half_rhythm"><div>Blood gases</div></li><li class="half_rhythm"><div>Full blood count</div></li><li class="half_rhythm"><div>White blood cell count</div></li><li class="half_rhythm"><div>Myxovirus resistance protein A</div></li><li class="half_rhythm"><div>TNF-related apoptosis-induced ligand (TRAIL)</div></li></ul></p></div></div><div id="niceng237er2.s4.1.2"><h4>4.1.2. C-reactive protein</h4><p>A recent systematic review<a class="bibr" href="#niceng237er2.ref16" rid="niceng237er2.ref16"><sup>16</sup></a> assessed POC biomarker tests to guide antibiotic treatment in people with ARI in primary care settings regardless of age. The scope differed from the present review in terms of patient age, setting, interventions and outcomes, but provided a subgroup meta-analysis for the effect of CRP testing on antibiotic use in adults. On closer inspection, we could not replicate the computation of the effective sample size for some of the cluster RCTs (<a href="#niceng237er2.app8">Appendix 8</a>), therefore we conducted new meta-analyses of outcomes for this test. The systematic review was used as a source of data for the relevant primary studies, in addition to the primary publications of the studies.</p><p>Ten RCTs (four of which were cluster RCTs) compared CRP POCT with usual care to guide antibiotic decisions (<a class="figpopup" href="/books/NBK598986/table/niceng237er2.tab1/?report=objectonly" target="object" rid-figpopup="figniceng237er2tab1" rid-ob="figobniceng237er2tab1">Table 1</a> and <a href="#niceng237er2.app6">Appendix 6</a>). All ten RCTs were included in the Smedemark 2022 review.<a class="bibr" href="#niceng237er2.ref16" rid="niceng237er2.ref16"><sup>16</sup></a> Date of publication ranged from 1995 to 2021, with only three of the primary reports published in the past 5 years. One study was conducted in the UK,<a class="bibr" href="#niceng237er2.ref24" rid="niceng237er2.ref24"><sup>24</sup></a> and another study was conducted in Europe, including the UK.<a class="bibr" href="#niceng237er2.ref25" rid="niceng237er2.ref25"><sup>25</sup></a> Three studies were conducted in The Netherlands,<a class="bibr" href="#niceng237er2.ref26" rid="niceng237er2.ref26"><sup>26</sup></a><sup>–</sup><a class="bibr" href="#niceng237er2.ref28" rid="niceng237er2.ref28"><sup>28</sup></a> and the remaining studies were conducted in each of Russia,<a class="bibr" href="#niceng237er2.ref29" rid="niceng237er2.ref29"><sup>29</sup></a> Thailand and Myanmar,<a class="bibr" href="#niceng237er2.ref30" rid="niceng237er2.ref30"><sup>30</sup></a> Denmark,<a class="bibr" href="#niceng237er2.ref31" rid="niceng237er2.ref31"><sup>31</sup></a> Norway<a class="bibr" href="#niceng237er2.ref32" rid="niceng237er2.ref32"><sup>32</sup></a> and North Vietnam.<a class="bibr" href="#niceng237er2.ref33" rid="niceng237er2.ref33"><sup>33</sup></a> Study sample sizes ranged from 179<a class="bibr" href="#niceng237er2.ref29" rid="niceng237er2.ref29"><sup>29</sup></a> to 1932 adults.<a class="bibr" href="#niceng237er2.ref25" rid="niceng237er2.ref25"><sup>25</sup></a></p><p>Five of the studies assessed a test not currently available in the UK (Nycocard II CRP point-of-care testing),<a class="bibr" href="#niceng237er2.ref26" rid="niceng237er2.ref26"><sup>26</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref30" rid="niceng237er2.ref30"><sup>30</sup></a><sup>–</sup><a class="bibr" href="#niceng237er2.ref33" rid="niceng237er2.ref33"><sup>33</sup></a> however a pragmatic decision was taken to include these studies. Two tests that are currently available in the UK were assessed: Afinion CRP point-of-care testing (two studies<a class="bibr" href="#niceng237er2.ref24" rid="niceng237er2.ref24"><sup>24</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref29" rid="niceng237er2.ref29"><sup>29</sup></a>) and QuikRead CRP (three studies<a class="bibr" href="#niceng237er2.ref25" rid="niceng237er2.ref25"><sup>25</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref27" rid="niceng237er2.ref27"><sup>27</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref28" rid="niceng237er2.ref28"><sup>28</sup></a>).</p><p>Eight studies were conducted in a primary care setting,<a class="bibr" href="#niceng237er2.ref24" rid="niceng237er2.ref24"><sup>24</sup></a><sup>–</sup><a class="bibr" href="#niceng237er2.ref26" rid="niceng237er2.ref26"><sup>26</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref28" rid="niceng237er2.ref28"><sup>28</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref29" rid="niceng237er2.ref29"><sup>29</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref31" rid="niceng237er2.ref31"><sup>31</sup></a><sup>–</sup><a class="bibr" href="#niceng237er2.ref33" rid="niceng237er2.ref33"><sup>33</sup></a> one in primary care and outpatients,<a class="bibr" href="#niceng237er2.ref30" rid="niceng237er2.ref30"><sup>30</sup></a> and one study was conducted in nursing homes.<a class="bibr" href="#niceng237er2.ref27" rid="niceng237er2.ref27"><sup>27</sup></a> There were some differences in the populations eligible for inclusion in the studies. Most included people with acute LRTI or upper or lower RTI, using slightly differing definitions, however Butler 2019<a class="bibr" href="#niceng237er2.ref24" rid="niceng237er2.ref24"><sup>24</sup></a> limited inclusion to people with acute exacerbation of COPD (AECOPD) (<a class="figpopup" href="/books/NBK598986/table/niceng237er2.tab1/?report=objectonly" target="object" rid-figpopup="figniceng237er2tab1" rid-ob="figobniceng237er2tab1">Table 1</a>). Three studies included children in their population; Do 2016<a class="bibr" href="#niceng237er2.ref33" rid="niceng237er2.ref33"><sup>33</sup></a> presented subgroup data for adults in their study of non-severe ARI, while Althaus 2019<a class="bibr" href="#niceng237er2.ref30" rid="niceng237er2.ref30"><sup>30</sup></a> and Diederichsen 2000<a class="bibr" href="#niceng237er2.ref31" rid="niceng237er2.ref31"><sup>31</sup></a>) provided raw data for adults with ARI to Smedemark 2022.<a class="bibr" href="#niceng237er2.ref16" rid="niceng237er2.ref16"><sup>16</sup></a></p><p>Three studies received funding or test kits from the manufacturer.<a class="bibr" href="#niceng237er2.ref28" rid="niceng237er2.ref28"><sup>28</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref29" rid="niceng237er2.ref29"><sup>29</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref32" rid="niceng237er2.ref32"><sup>32</sup></a></p><div id="niceng237er2.s4.1.2.1"><h5>4.1.2.1. Risk of bias in included CRP studies</h5><p>The overall risk of bias was considered high for all ten studies assessing CRP POC tests because of the lack of blinding of participants and personnel (<a href="#niceng237er2.app9">Appendix 9</a>).<a class="bibr" href="#niceng237er2.ref24" rid="niceng237er2.ref24"><sup>24</sup></a><sup>–</sup><a class="bibr" href="#niceng237er2.ref33" rid="niceng237er2.ref33"><sup>33</sup></a> In addition, six studies were considered to have an unclear risk of selection bias due to unclear allocation concealment,<a class="bibr" href="#niceng237er2.ref25" rid="niceng237er2.ref25"><sup>25</sup></a><sup>–</sup><a class="bibr" href="#niceng237er2.ref27" rid="niceng237er2.ref27"><sup>27</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref29" rid="niceng237er2.ref29"><sup>29</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref31" rid="niceng237er2.ref31"><sup>31</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref32" rid="niceng237er2.ref32"><sup>32</sup></a> and four studies were considered to be at high risk of bias because of ‘other bias.’<a class="bibr" href="#niceng237er2.ref25" rid="niceng237er2.ref25"><sup>25</sup></a><sup>–</sup><a class="bibr" href="#niceng237er2.ref27" rid="niceng237er2.ref27"><sup>27</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref29" rid="niceng237er2.ref29"><sup>29</sup></a> One study was at high risk of bias due to lack of blinding in the assessment of ‘other outcomes’.<a class="bibr" href="#niceng237er2.ref32" rid="niceng237er2.ref32"><sup>32</sup></a> Based on reviewer’s judgments, one study was considered at high risk of bias due to incomplete outcome data reporting for 7- or 28-day mortality and hospital admission (immediately after triage or at 28 days).<a class="bibr" href="#niceng237er2.ref27" rid="niceng237er2.ref27"><sup>27</sup></a> Two studies were at high risk of bias due to incomplete outcome reporting for ‘other outcomes’ (i.e. antibiotic/antiviral use, hospital length of stay, follow-up consultation/ongoing monitoring, time to clinical cure/resolution of symptoms, and HRQoL).<a class="bibr" href="#niceng237er2.ref24" rid="niceng237er2.ref24"><sup>24</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref33" rid="niceng237er2.ref33"><sup>33</sup></a> Risk of bias for other domains (e.g. random sequence generation and selective reporting) were considered to be low or unclear (<a href="#niceng237er2.app9">Appendix 9</a>).</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng237er2tab1"><a href="/books/NBK598986/table/niceng237er2.tab1/?report=objectonly" target="object" title="Table 1" class="img_link icnblk_img figpopup" rid-figpopup="figniceng237er2tab1" rid-ob="figobniceng237er2tab1"><img class="small-thumb" src="/books/NBK598986/table/niceng237er2.tab1/?report=thumb" src-large="/books/NBK598986/table/niceng237er2.tab1/?report=previmg" alt="Table 1. Characteriscs of included studies for C-reacve protein point of care tests." /></a><div class="icnblk_cntnt"><h4 id="niceng237er2.tab1"><a href="/books/NBK598986/table/niceng237er2.tab1/?report=objectonly" target="object" rid-ob="figobniceng237er2tab1">Table 1</a></h4><p class="float-caption no_bottom_margin">Characteriscs of included studies for C-reacve protein point of care tests. </p></div></div></div><div id="niceng237er2.s4.1.2.2"><h5>4.1.2.2. Hospital admission (immediately after triage or at 28 days)</h5><p>No eligible evidence was identified for hospital admission immediately after triage.</p><p>Four cluster RCTs<a class="bibr" href="#niceng237er2.ref25" rid="niceng237er2.ref25"><sup>25</sup></a><sup>–</sup><a class="bibr" href="#niceng237er2.ref27" rid="niceng237er2.ref27"><sup>27</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref29" rid="niceng237er2.ref29"><sup>29</sup></a> and two individual RCTs<a class="bibr" href="#niceng237er2.ref24" rid="niceng237er2.ref24"><sup>24</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref28" rid="niceng237er2.ref28"><sup>28</sup></a> reported data on hospital admissions at varying timepoints (where reported), ranging from two weeks<a class="bibr" href="#niceng237er2.ref29" rid="niceng237er2.ref29"><sup>29</sup></a> to six months.<a class="bibr" href="#niceng237er2.ref24" rid="niceng237er2.ref24"><sup>24</sup></a> It was not possible to calculate risk ratios for two cluster-RCTs<a class="bibr" href="#niceng237er2.ref26" rid="niceng237er2.ref26"><sup>26</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref29" rid="niceng237er2.ref29"><sup>29</sup></a> and one individual RCT<a class="bibr" href="#niceng237er2.ref28" rid="niceng237er2.ref28"><sup>28</sup></a> due to zero events in both intervention arms. Three RCTs provided data allowing calculation of risk ratios: two cluster-RCTs with follow-up between 3-4 week reported very few events;<a class="bibr" href="#niceng237er2.ref25" rid="niceng237er2.ref25"><sup>25</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref27" rid="niceng237er2.ref27"><sup>27</sup></a> one RCT with follow-up at 6 months showed no difference between CRP and usual care groups, RR 1.02 (95% CI 0.65 to 1.59; 1 RCT, n=605; very low certainty evidence).<a class="bibr" href="#niceng237er2.ref24" rid="niceng237er2.ref24"><sup>24</sup></a></p><p>Meta-analysis was not conducted for the studies reporting hospital admissions due to the very different duration of follow-up. However, data are presented as a forest plot in <a class="figpopup" href="/books/NBK598986/figure/niceng237er2.fig1/?report=objectonly" target="object" rid-figpopup="figniceng237er2fig1" rid-ob="figobniceng237er2fig1">Figure 1</a>.</p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figniceng237er2fig1" co-legend-rid="figlgndniceng237er2fig1"><a href="/books/NBK598986/figure/niceng237er2.fig1/?report=objectonly" target="object" title="Figure 1" class="img_link icnblk_img figpopup" rid-figpopup="figniceng237er2fig1" rid-ob="figobniceng237er2fig1"><img class="small-thumb" src="/books/NBK598986/bin/niceng237er2f1.gif" src-large="/books/NBK598986/bin/niceng237er2f1.jpg" alt="Figure 1. CRP POCT vs usual care - Hospital Admission." /></a><div class="icnblk_cntnt" id="figlgndniceng237er2fig1"><h4 id="niceng237er2.fig1"><a href="/books/NBK598986/figure/niceng237er2.fig1/?report=objectonly" target="object" rid-ob="figobniceng237er2fig1">Figure 1</a></h4><p class="float-caption no_bottom_margin">CRP POCT vs usual care - Hospital Admission. </p></div></div></div><div id="niceng237er2.s4.1.2.3"><h5>4.1.2.3. Escalation of care (some time after initial consultation): Re-consultation/appointment</h5><p>Three cluster RCTs<a class="bibr" href="#niceng237er2.ref25" rid="niceng237er2.ref25"><sup>25</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref26" rid="niceng237er2.ref26"><sup>26</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref29" rid="niceng237er2.ref29"><sup>29</sup></a> and one individual RCT<a class="bibr" href="#niceng237er2.ref28" rid="niceng237er2.ref28"><sup>28</sup></a> reported data on the number of re-consultations at 14 days,<a class="bibr" href="#niceng237er2.ref29" rid="niceng237er2.ref29"><sup>29</sup></a> or at 28 days,<a class="bibr" href="#niceng237er2.ref26" rid="niceng237er2.ref26"><sup>26</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref28" rid="niceng237er2.ref28"><sup>28</sup></a> or re-consultations due to ‘new or worsening symptoms’ within 28 days.<a class="bibr" href="#niceng237er2.ref25" rid="niceng237er2.ref25"><sup>25</sup></a> The pooled result for all included studies showed that CRP POCT may increase the risk of needing a re-consultation compared to usual care (<a class="figpopup" href="/books/NBK598986/figure/niceng237er2.fig2/?report=objectonly" target="object" rid-figpopup="figniceng237er2fig2" rid-ob="figobniceng237er2fig2">Figure 2</a>): RR 1.61 (95% CI 1.07 to 2.41, I<sup>2</sup>=56.6%; 4 RCTs/cluster-RCTs, n=1,433; very low certainty evidence).</p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figniceng237er2fig2" co-legend-rid="figlgndniceng237er2fig2"><a href="/books/NBK598986/figure/niceng237er2.fig2/?report=objectonly" target="object" title="Figure 2" class="img_link icnblk_img figpopup" rid-figpopup="figniceng237er2fig2" rid-ob="figobniceng237er2fig2"><img class="small-thumb" src="/books/NBK598986/bin/niceng237er2f2.gif" src-large="/books/NBK598986/bin/niceng237er2f2.jpg" alt="Figure 2. CRP POCT vs usual care - Escalation of care: number of re-consultations." /></a><div class="icnblk_cntnt" id="figlgndniceng237er2fig2"><h4 id="niceng237er2.fig2"><a href="/books/NBK598986/figure/niceng237er2.fig2/?report=objectonly" target="object" rid-ob="figobniceng237er2fig2">Figure 2</a></h4><p class="float-caption no_bottom_margin">CRP POCT vs usual care - Escalation of care: number of re-consultations. </p></div></div></div><div id="niceng237er2.s4.1.2.4"><h5>4.1.2.4. Escalation of care (some time after initial consultation): Virtual Ward</h5><p>No eligible evidence was identified for this outcome.</p></div><div id="niceng237er2.s4.1.2.5"><h5>4.1.2.5. Escalation of care (some time after initial consultation): Emergency department visit</h5><p>No eligible evidence was identified for this outcome.</p></div><div id="niceng237er2.s4.1.2.6"><h5>4.1.2.6. Escalation of care (some time after initial consultation): Unplanned hospital admission</h5><p>No eligible evidence was identified for this outcome.</p></div><div id="niceng237er2.s4.1.2.7"><h5>4.1.2.7. Hospital length of stay</h5><p>No eligible evidence was identified for this outcome.</p></div><div id="niceng237er2.s4.1.2.8"><h5>4.1.2.8. Follow-up consultation/ongoing monitoring</h5><p>No eligible evidence was identified for this outcome.</p></div><div id="niceng237er2.s4.1.2.9"><h5>4.1.2.9. Antibiotic/antiviral use</h5><p>Three cluster RCTs<a class="bibr" href="#niceng237er2.ref26" rid="niceng237er2.ref26"><sup>26</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref27" rid="niceng237er2.ref27"><sup>27</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref29" rid="niceng237er2.ref29"><sup>29</sup></a> and six individual RCTs<a class="bibr" href="#niceng237er2.ref24" rid="niceng237er2.ref24"><sup>24</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref28" rid="niceng237er2.ref28"><sup>28</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref30" rid="niceng237er2.ref30"><sup>30</sup></a><sup>–</sup><a class="bibr" href="#niceng237er2.ref33" rid="niceng237er2.ref33"><sup>33</sup></a> provided evidence on the number of antibiotics prescribed at index consultation. The pooled result for all included studies showed CRP POCT may reduce the risk of antibiotic prescribing at index consultation compared to usual care (<a class="figpopup" href="/books/NBK598986/figure/niceng237er2.fig3/?report=objectonly" target="object" rid-figpopup="figniceng237er2fig3" rid-ob="figobniceng237er2fig3">Figure 3</a>): RR 0.75 (95% CI 0.68 to 0.84, I<sup>2</sup>=54.7%; 9 RCTs/cluster-RCTs, n=4,027). Heterogeneity among estimated effects between individually randomised trials.</p><p>In contrast to the Smedemark 2022 review,<a class="bibr" href="#niceng237er2.ref16" rid="niceng237er2.ref16"><sup>16</sup></a> data on antibiotics prescribed at index consultation for Little 2013<a class="bibr" href="#niceng237er2.ref25" rid="niceng237er2.ref25"><sup>25</sup></a> and Little 2019<a class="bibr" href="#niceng237er2.ref37" rid="niceng237er2.ref37"><sup>37</sup></a> were excluded from meta-analysis in the current review because it was clear from Little 2019<a class="bibr" href="#niceng237er2.ref37" rid="niceng237er2.ref37"><sup>37</sup></a> that the data related to antibiotics prescribed at 3 months. The data reported at three months also appeared to be based on GP practices, suggesting the data reported was not necessarily follow-up of the same patients initially included in the study (see <a href="#niceng237er2.app8">Appendix 8</a>).</p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figniceng237er2fig3" co-legend-rid="figlgndniceng237er2fig3"><a href="/books/NBK598986/figure/niceng237er2.fig3/?report=objectonly" target="object" title="Figure 3" class="img_link icnblk_img figpopup" rid-figpopup="figniceng237er2fig3" rid-ob="figobniceng237er2fig3"><img class="small-thumb" src="/books/NBK598986/bin/niceng237er2f3.gif" src-large="/books/NBK598986/bin/niceng237er2f3.jpg" alt="Figure 3. CRP POCT vs usual care - Antibiotics prescribed at index consultation." /></a><div class="icnblk_cntnt" id="figlgndniceng237er2fig3"><h4 id="niceng237er2.fig3"><a href="/books/NBK598986/figure/niceng237er2.fig3/?report=objectonly" target="object" rid-ob="figobniceng237er2fig3">Figure 3</a></h4><p class="float-caption no_bottom_margin">CRP POCT vs usual care - Antibiotics prescribed at index consultation. </p></div></div><p>Two cluster RCTs<a class="bibr" href="#niceng237er2.ref26" rid="niceng237er2.ref26"><sup>26</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref29" rid="niceng237er2.ref29"><sup>29</sup></a> and four individual RCTs<a class="bibr" href="#niceng237er2.ref24" rid="niceng237er2.ref24"><sup>24</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref28" rid="niceng237er2.ref28"><sup>28</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref32" rid="niceng237er2.ref32"><sup>32</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref33" rid="niceng237er2.ref33"><sup>33</sup></a> also provided evidence on the number of antibiotics prescribed within 14 or 28 days. The pooled result for all included studies showed that CRP POCT may reduce the risk of antibiotic prescribing within 14 or 28 days compared to usual care (<a class="figpopup" href="/books/NBK598986/figure/niceng237er2.fig4/?report=objectonly" target="object" rid-figpopup="figniceng237er2fig4" rid-ob="figobniceng237er2fig4">Figure 4</a>): RR 0.79 (95% CI 0.73 to 0.85, I<sup>2</sup>=24.4%; 6 RCTs/cluster-RCTs, n=2,251).</p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figniceng237er2fig4" co-legend-rid="figlgndniceng237er2fig4"><a href="/books/NBK598986/figure/niceng237er2.fig4/?report=objectonly" target="object" title="Figure 4" class="img_link icnblk_img figpopup" rid-figpopup="figniceng237er2fig4" rid-ob="figobniceng237er2fig4"><img class="small-thumb" src="/books/NBK598986/bin/niceng237er2f4.gif" src-large="/books/NBK598986/bin/niceng237er2f4.jpg" alt="Figure 4. CRP POCT vs usual care - Antibiotics prescribed within 28 days." /></a><div class="icnblk_cntnt" id="figlgndniceng237er2fig4"><h4 id="niceng237er2.fig4"><a href="/books/NBK598986/figure/niceng237er2.fig4/?report=objectonly" target="object" rid-ob="figobniceng237er2fig4">Figure 4</a></h4><p class="float-caption no_bottom_margin">CRP POCT vs usual care - Antibiotics prescribed within 28 days. </p></div></div><p>Three studies reported additional data relating to antibiotic use or changes to antibiotic treatment that could not be meta-analysed.<a class="bibr" href="#niceng237er2.ref24" rid="niceng237er2.ref24"><sup>24</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref27" rid="niceng237er2.ref27"><sup>27</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref33" rid="niceng237er2.ref33"><sup>33</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref34" rid="niceng237er2.ref34"><sup>34</sup></a> Butler 2019<a class="bibr" href="#niceng237er2.ref24" rid="niceng237er2.ref24"><sup>24</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref34" rid="niceng237er2.ref34"><sup>34</sup></a> assessed patient-reported antibiotic use for an AECOPD within four weeks after randomisation and found a reduction in antibiotic consumption in the CRP group (57.0%) compared to the usual care group (77.4%): adjusted OR 0.31 (95% CI 0.20 to 0.47; 1 RCT, n=537).</p><p>Boere 2021<a class="bibr" href="#niceng237er2.ref27" rid="niceng237er2.ref27"><sup>27</sup></a> found that antibiotic treatment changes (start, cessation, switch, or prolongation) occurred less frequently in the CRP group during follow-up (12.2%) compared with usual care group (16.8%), OR 0.53 (95% CI 0.26 to 1.08; 1 cluster-RCT); Do 2016<a class="bibr" href="#niceng237er2.ref33" rid="niceng237er2.ref33"><sup>33</sup></a> found a small difference between the CRP group and usual care group in terms of subsequent antibiotic use in those without an immediate antibiotic prescription, 30.0% versus 34.2% respectively, OR 0.73 (95% CI 0.45 to 1.17; 1 RCT, n=386), and a small increase in terms of antibiotic management changes in those without an immediate antibiotic prescription between the CRP group (8.6%) and usual care group (4.6%): OR 1.99 (95% CI 0.86 to 4.64; 1 RCT, n=430). All the above evidence was highly uncertain.</p></div><div id="niceng237er2.s4.1.2.10"><h5>4.1.2.10. Time to clinical cure/resolution of symptoms</h5><p>Three studies provided evidence on time to resolution of symptoms/time to full recovery (<a class="figpopup" href="/books/NBK598986/table/niceng237er2.tab2/?report=objectonly" target="object" rid-figpopup="figniceng237er2tab2" rid-ob="figobniceng237er2tab2">Table 2</a>).<a class="bibr" href="#niceng237er2.ref16" rid="niceng237er2.ref16"><sup>16</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref25" rid="niceng237er2.ref25"><sup>25</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref28" rid="niceng237er2.ref28"><sup>28</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref33" rid="niceng237er2.ref33"><sup>33</sup></a></p><p>Do 2016 and Little 2013 found no significant difference between the CRP and usual care groups in time to resolution of symptoms/moderately bad symptoms: HR 0.89 (95% CI 0.77 to 1.03; 1 RCT)<a class="bibr" href="#niceng237er2.ref33" rid="niceng237er2.ref33"><sup>33</sup></a> and adjusted HR 0.87 (95% CI 0.74 to 1.03; 1 cluster-RCT)<a class="bibr" href="#niceng237er2.ref16" rid="niceng237er2.ref16"><sup>16</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref25" rid="niceng237er2.ref25"><sup>25</sup></a></p><p>Similarly, Cals 2010 found little difference between the CRP and usual care groups in terms of patient reported time to full recovery for patients with lower RTI (CRP mean 17.5 days (SD 9.2), usual care mean 19.8 days (SD 9.5); 1 cluster-RCT, n=100) or patients with rhinosinusitis (CRP mean 17.3 days (SD 9.3) and usual care mean 16.6 days (SD 9.9); 1 cluster-RCT, n=143).<a class="bibr" href="#niceng237er2.ref28" rid="niceng237er2.ref28"><sup>28</sup></a></p><p>In addition, five studies provided evidence on the number of patients substantially improved (<a class="figpopup" href="/books/NBK598986/table/niceng237er2.tab3/?report=objectonly" target="object" rid-figpopup="figniceng237er2tab3" rid-ob="figobniceng237er2tab3">Table 3</a>). Two studies reported the number of patients substantially improved within 7 days, with both studies showing no significant differences between CRP and usual care groups: RR 0.94 (95% CI 0.75 to 1.18; 1 RCT, n=230)<a class="bibr" href="#niceng237er2.ref16" rid="niceng237er2.ref16"><sup>16</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref32" rid="niceng237er2.ref32"><sup>32</sup></a> and RR 1.03 (95% CI 0.89 to 1.18; 1 RCT, n=243)<a class="bibr" href="#niceng237er2.ref16" rid="niceng237er2.ref16"><sup>16</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref28" rid="niceng237er2.ref28"><sup>28</sup></a></p><p>One study reported a similar proportion of patients fully or almost recovered within 14 days between the CRP group (91.1%; n=101, original sample size) and usual care group (92.3%; n=78, original sample size).<a class="bibr" href="#niceng237er2.ref29" rid="niceng237er2.ref29"><sup>29</sup></a>
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<a class="bibr" href="#niceng237er2.ref16" rid="niceng237er2.ref16"><sup>16</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref29" rid="niceng237er2.ref29"><sup>29</sup></a></p><p>One study found no significant difference in the number of patients fully recovered within 3 weeks between the CRP group (86.4%) and usual care group (90.8%), OR 0.49 (0.21 to 1.12).<a class="bibr" href="#niceng237er2.ref27" rid="niceng237er2.ref27"><sup>27</sup></a> The sample sizes these proportions were based on were unclear and did not align with the original sample sizes in each group.</p><p>Two studies reporting on the number of patients substantially improved at 28 days found no significant difference between the CRP group and usual care group: RR 0.97 (95% CI 0.53 to 1.78; 1 cluster-RCT [modified sample size due to cluster level data, n=124)<a class="bibr" href="#niceng237er2.ref16" rid="niceng237er2.ref16"><sup>16</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref26" rid="niceng237er2.ref26"><sup>26</sup></a> and RR 0.85 (95% CI 0.57 to 1.29; 1 RCT, n=219).<a class="bibr" href="#niceng237er2.ref16" rid="niceng237er2.ref16"><sup>16</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref32" rid="niceng237er2.ref32"><sup>32</sup></a></p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng237er2tab2"><a href="/books/NBK598986/table/niceng237er2.tab2/?report=objectonly" target="object" title="Table 2" class="img_link icnblk_img figpopup" rid-figpopup="figniceng237er2tab2" rid-ob="figobniceng237er2tab2"><img class="small-thumb" src="/books/NBK598986/table/niceng237er2.tab2/?report=thumb" src-large="/books/NBK598986/table/niceng237er2.tab2/?report=previmg" alt="Table 2. CRP POCT vs usual care - Time to resoluon of symptoms/me to full recovery." /></a><div class="icnblk_cntnt"><h4 id="niceng237er2.tab2"><a href="/books/NBK598986/table/niceng237er2.tab2/?report=objectonly" target="object" rid-ob="figobniceng237er2tab2">Table 2</a></h4><p class="float-caption no_bottom_margin">CRP POCT vs usual care - Time to resoluon of symptoms/me to full recovery. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng237er2tab3"><a href="/books/NBK598986/table/niceng237er2.tab3/?report=objectonly" target="object" title="Table 3" class="img_link icnblk_img figpopup" rid-figpopup="figniceng237er2tab3" rid-ob="figobniceng237er2tab3"><img class="small-thumb" src="/books/NBK598986/table/niceng237er2.tab3/?report=thumb" src-large="/books/NBK598986/table/niceng237er2.tab3/?report=previmg" alt="Table 3. CRP POCT vs usual care - Number of paents substanally improved." /></a><div class="icnblk_cntnt"><h4 id="niceng237er2.tab3"><a href="/books/NBK598986/table/niceng237er2.tab3/?report=objectonly" target="object" rid-ob="figobniceng237er2tab3">Table 3</a></h4><p class="float-caption no_bottom_margin">CRP POCT vs usual care - Number of paents substanally improved. </p></div></div></div><div id="niceng237er2.s4.1.2.11"><h5>4.1.2.11. Mortality</h5><p>Three cluster RCTs<a class="bibr" href="#niceng237er2.ref25" rid="niceng237er2.ref25"><sup>25</sup></a><sup>–</sup><a class="bibr" href="#niceng237er2.ref27" rid="niceng237er2.ref27"><sup>27</sup></a> and three individual RCTs<a class="bibr" href="#niceng237er2.ref24" rid="niceng237er2.ref24"><sup>24</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref28" rid="niceng237er2.ref28"><sup>28</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref33" rid="niceng237er2.ref33"><sup>33</sup></a> provided evidence on mortality rates at varying timepoints. It was not possible to calculate risk ratios for two cluster-RCTs<a class="bibr" href="#niceng237er2.ref25" rid="niceng237er2.ref25"><sup>25</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref26" rid="niceng237er2.ref26"><sup>26</sup></a> and two individual RCTs<a class="bibr" href="#niceng237er2.ref28" rid="niceng237er2.ref28"><sup>28</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref33" rid="niceng237er2.ref33"><sup>33</sup></a> due to zero events in both intervention and usual care arms. Two RCTs provided data to calculate risk ratios but the event rates were very low.<a class="bibr" href="#niceng237er2.ref24" rid="niceng237er2.ref24"><sup>24</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref27" rid="niceng237er2.ref27"><sup>27</sup></a></p><p>Meta-analysis was not conducted, however, data are presented as a forest plot in <a class="figpopup" href="/books/NBK598986/figure/niceng237er2.fig5/?report=objectonly" target="object" rid-figpopup="figniceng237er2fig5" rid-ob="figobniceng237er2fig5">Figure 5</a>.</p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figniceng237er2fig5" co-legend-rid="figlgndniceng237er2fig5"><a href="/books/NBK598986/figure/niceng237er2.fig5/?report=objectonly" target="object" title="Figure 5" class="img_link icnblk_img figpopup" rid-figpopup="figniceng237er2fig5" rid-ob="figobniceng237er2fig5"><img class="small-thumb" src="/books/NBK598986/bin/niceng237er2f5.gif" src-large="/books/NBK598986/bin/niceng237er2f5.jpg" alt="Figure 5. CRP POCT vs usual care - Mortality." /></a><div class="icnblk_cntnt" id="figlgndniceng237er2fig5"><h4 id="niceng237er2.fig5"><a href="/books/NBK598986/figure/niceng237er2.fig5/?report=objectonly" target="object" rid-ob="figobniceng237er2fig5">Figure 5</a></h4><p class="float-caption no_bottom_margin">CRP POCT vs usual care - Mortality. </p></div></div></div><div id="niceng237er2.s4.1.2.12"><h5>4.1.2.12. HRQoL</h5><p>One UK study reported HRQoL (<a href="#niceng237er2.app6">Appendix 6</a>, <a href="#niceng237er2.app6.et1">Table 11</a>), measured using the EQ-5D-5L index value, EQ-5D visual analogue scale (VAS; with scores ranging from 0 to 100 and higher scores indicating better health), and the CRQ-SAS which measures disease-specific health-related quality of life, including domains for dyspnoea, fatigue, emotional functioning and mastery (scores range from 1 to 7 with higher scores indicating better patient outcomes for each domain).<a class="bibr" href="#niceng237er2.ref24" rid="niceng237er2.ref24"><sup>24</sup></a></p><p>No differences were found between patients in the CRP group compared with patients in the usual care group for EQ-5D-5L index values measured across different timepoints (i.e. at weeks 1, 2 and 4, and at 6 months): adjusted mean difference 0.03 (95% CI −0.04 to 0.09; 1 RCT). By contrast, EQ-5D VAS scores were 3 points higher in the CRP group compared to usual care group measured across different timepoints (i.e. at weeks 1, 2 and 4, and at 6 months): adjusted mean difference 3.12 (95% CI 0.50 to 5.74; 1 RCT).<a class="bibr" href="#niceng237er2.ref24" rid="niceng237er2.ref24"><sup>24</sup></a></p><p>No differences were found between the CRP and usual care groups for any CRQ-SAS domain at 6 month follow-up: adjusted mean difference for dyspnoea domain 0.06 (95% CI −0.20 to 0.33; 1 RCT, n=399); adjusted mean difference for fatigue domain 0.13 (95% CI −0.12 to 0.38; 1 RCT, n=436); adjusted mean difference for emotional function domain 0.15 (95% CI −0.04 to 0.34; 1 RCT, n=441); adjusted mean difference for mastery domain −0.09 (95% CI −0.18 to 0.01; 1 RCT, n=435).<a class="bibr" href="#niceng237er2.ref24" rid="niceng237er2.ref24"><sup>24</sup></a></p></div><div id="niceng237er2.s4.1.2.13"><h5>4.1.2.13. Subgroup and sensitivity analyses for clinical effectiveness outcomes</h5><p>Only one subgroup analysis was performed due to limited data. This subgroup analysis of antibiotics prescribed at index consultation included only patients with COPD.<a class="bibr" href="#niceng237er2.ref24" rid="niceng237er2.ref24"><sup>24</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref27" rid="niceng237er2.ref27"><sup>27</sup></a> Sensitivity analyses were conducted to assess the impact of excluding one study each in patients with AECOPD<a class="bibr" href="#niceng237er2.ref24" rid="niceng237er2.ref24"><sup>24</sup></a> or in a nursing home setting,<a class="bibr" href="#niceng237er2.ref27" rid="niceng237er2.ref27"><sup>27</sup></a> on antibiotics prescribed at index consultation or at 28 days. Sensitivity analyses were also conducted to assess the impact of excluding studies using tests that are unavailable in the UK on antibiotics prescribed at index consultation, within 28 days, or on the escalation of care.<a class="bibr" href="#niceng237er2.ref26" rid="niceng237er2.ref26"><sup>26</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref30" rid="niceng237er2.ref30"><sup>30</sup></a><sup>–</sup><a class="bibr" href="#niceng237er2.ref33" rid="niceng237er2.ref33"><sup>33</sup></a> I Findings for subgroup and sensitivity analyses did not change the conclusions inferred from the main analyses (<a href="#niceng237er2.app11">Appendix 11</a>).</p></div></div><div id="niceng237er2.s4.1.3"><h4>4.1.3. Procalcitonin</h4><p>The recent systematic review<a class="bibr" href="#niceng237er2.ref16" rid="niceng237er2.ref16"><sup>16</sup></a> assessed POC biomarker tests to guide antibiotic treatment in people with ARI in primary care settings regardless of age. The scope differed from the present review in terms of patient age, setting, interventions and outcomes, but provided data for one included cluster RCT on the effects of procalcitonin testing.<a class="bibr" href="#niceng237er2.ref38" rid="niceng237er2.ref38"><sup>38</sup></a> The systematic review was used as a source of data for the RCT, in addition to the primary publication of the RCT. No additional RCTs were identified by our searches.</p><p>The RCT assessed the use of POC procalcitonin (BRAHMS PCT direct point-of-care test) to guide antibiotic decisions in adults with acute cough in a primary care setting in Switzerland (<a class="figpopup" href="/books/NBK598986/table/niceng237er2.tab4/?report=objectonly" target="object" rid-figpopup="figniceng237er2tab4" rid-ob="figobniceng237er2tab4">Table 4</a> and <a href="#niceng237er2.app6">Appendix 6</a>).<a class="bibr" href="#niceng237er2.ref38" rid="niceng237er2.ref38"><sup>38</sup></a></p><p>Funding was non-commercial, although test kits were provided by the manufacturer.</p><div id="niceng237er2.s4.1.3.1"><h5>4.1.3.1. Risk of bias in included procalcitonin study</h5><p>Based on the Cochrane Review assessment,<a class="bibr" href="#niceng237er2.ref16" rid="niceng237er2.ref16"><sup>16</sup></a> the single study assessing procalcitonin<a class="bibr" href="#niceng237er2.ref38" rid="niceng237er2.ref38"><sup>38</sup></a> was considered to be at high risk of bias due to lack of blinding of participants and personnel, and selection bias due to unclear allocation concealment and lack of individual randomisation. The remaining risk of bias domains were considered to be low or unclear risk. Based on reviewer’s judgements, the study was also at high risk of bias due to incomplete outcome reporting for 7- or 28-day mortality (<a href="#niceng237er2.app9">Appendix 9</a>).</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng237er2tab4"><a href="/books/NBK598986/table/niceng237er2.tab4/?report=objectonly" target="object" title="Table 4" class="img_link icnblk_img figpopup" rid-figpopup="figniceng237er2tab4" rid-ob="figobniceng237er2tab4"><img class="small-thumb" src="/books/NBK598986/table/niceng237er2.tab4/?report=thumb" src-large="/books/NBK598986/table/niceng237er2.tab4/?report=previmg" alt="Table 4. Characteriscs of included studies for procalcitonin tests." /></a><div class="icnblk_cntnt"><h4 id="niceng237er2.tab4"><a href="/books/NBK598986/table/niceng237er2.tab4/?report=objectonly" target="object" rid-ob="figobniceng237er2tab4">Table 4</a></h4><p class="float-caption no_bottom_margin">Characteriscs of included studies for procalcitonin tests. </p></div></div></div><div id="niceng237er2.s4.1.3.2"><h5>4.1.3.2. Hospital admission (immediately after triage or at 28 days)</h5><p>No difference was found between procalcitonin and usual care in the number of patients in need of hospital admission within 7 days follow-up (RR 1.40, 95% CI 0.26 to 7.51; 1 cluster-RCT, n=277, very low certainty evidence).<a class="bibr" href="#niceng237er2.ref16" rid="niceng237er2.ref16"><sup>16</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref38" rid="niceng237er2.ref38"><sup>38</sup></a></p></div><div id="niceng237er2.s4.1.3.3"><h5>4.1.3.3. Escalation of care (some time after initial consultation): Re-consultation/appointment</h5><p>No difference was found between procalcitonin and usual care in the number of adults in need of a re-consultation within 28 days follow-up (RR 1.00, 95% CI 0.69 to 1.46; 1 cluster-RCT, n=317; very low certainty evidence).<a class="bibr" href="#niceng237er2.ref16" rid="niceng237er2.ref16"><sup>16</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref38" rid="niceng237er2.ref38"><sup>38</sup></a></p></div><div id="niceng237er2.s4.1.3.4"><h5>4.1.3.4. Escalation of care (some time after initial consultation): Virtual Ward</h5><p>No eligible evidence was identified for this outcome.</p></div><div id="niceng237er2.s4.1.3.5"><h5>4.1.3.5. Escalation of care (some time after initial consultation): Emergency department visit</h5><p>No eligible evidence was identified for this outcome.</p></div><div id="niceng237er2.s4.1.3.6"><h5>4.1.3.6. Escalation of care (some time after initial consultation): Unplanned hospital admission</h5><p>No eligible evidence was identified for this outcome.</p></div><div id="niceng237er2.s4.1.3.7"><h5>4.1.3.7. Hospital length of stay</h5><p>No eligible evidence was identified for this outcome.</p></div><div id="niceng237er2.s4.1.3.8"><h5>4.1.3.8. Follow-up consultation/ongoing monitoring</h5><p>No eligible evidence was identified for this outcome.</p></div><div id="niceng237er2.s4.1.3.9"><h5>4.1.3.9. Antibiotic/antiviral use</h5><p>At the index consultation, antibiotic prescriptions were substantially lower in the procalcitonin group compared to usual care group (RR 0.32, 95% CI 0.23 to 0.44; 1 cluster-RCT, n=317).<a class="bibr" href="#niceng237er2.ref16" rid="niceng237er2.ref16"><sup>16</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref38" rid="niceng237er2.ref38"><sup>38</sup></a></p><p>Similarly, the number of antibiotic prescriptions was substantially lower in the procalcitonin group compared to the usual care group within 7 days (29.7% versus 61.5%, respectively; 1 cluster-RCT, n=317) and within 28 days follow-up (40.0% versus 70.5%, respectively; 1 cluster-RCT, n=277).<a class="bibr" href="#niceng237er2.ref38" rid="niceng237er2.ref38"><sup>38</sup></a></p></div><div id="niceng237er2.s4.1.3.10"><h5>4.1.3.10. Time to clinical cure/resolution of symptoms</h5><p>No difference in median duration of symptoms by day 28 between the procalcitonin group (8 days) and usual care group (7 days): HR 0.81 (95% CI 0.62 to 1.04; 1 cluster-RCT, n=261).<a class="bibr" href="#niceng237er2.ref38" rid="niceng237er2.ref38"><sup>38</sup></a></p></div><div id="niceng237er2.s4.1.3.11"><h5>4.1.3.11. Mortality</h5><p>No deaths occurred in the procalcitonin group (0/163) or usual care group (0/114); 1 cluster-RCT, n=317; very low certainty evidence).<a class="bibr" href="#niceng237er2.ref38" rid="niceng237er2.ref38"><sup>38</sup></a></p></div><div id="niceng237er2.s4.1.3.12"><h5>4.1.3.12. HRQoL</h5><p>No eligible evidence was identified for this outcome.</p></div></div><div id="niceng237er2.s4.1.4"><h4>4.1.4. Rapid antigen test - Group A Streptococcus tests</h4><p>Two cluster RCTs assessed the effects of RADT Group A Streptococcus tests in adults with acute sore throat (RADT OSOM® Strep A<a class="bibr" href="#niceng237er2.ref39" rid="niceng237er2.ref39"><sup>39</sup></a> and RADT Clearview® Exact Strep A (<a class="figpopup" href="/books/NBK598986/table/niceng237er2.tab5/?report=objectonly" target="object" rid-figpopup="figniceng237er2tab5" rid-ob="figobniceng237er2tab5">Table 5</a> and <a href="#niceng237er2.app6">Appendix 6</a>).<a class="bibr" href="#niceng237er2.ref40" rid="niceng237er2.ref40"><sup>40</sup></a> The studies were conducted in 2011 and 2007, in Spain and Canada, respectively. Sample sizes in the relevant intervention groups were 557<a class="bibr" href="#niceng237er2.ref39" rid="niceng237er2.ref39"><sup>39</sup></a> and 261.<a class="bibr" href="#niceng237er2.ref40" rid="niceng237er2.ref40"><sup>40</sup></a> One of the studies included people aged 14 years or over,<a class="bibr" href="#niceng237er2.ref39" rid="niceng237er2.ref39"><sup>39</sup></a> which is different from the present review criteria, but a pragmatic decision was made to include it as the difference is only slight. Funding was non-commercial in one study<a class="bibr" href="#niceng237er2.ref39" rid="niceng237er2.ref39"><sup>39</sup></a> and not reported in the other study.<a class="bibr" href="#niceng237er2.ref40" rid="niceng237er2.ref40"><sup>40</sup></a></p><div id="niceng237er2.s4.1.4.1"><h5>4.1.4.1. Risk of bias in included of Group A Streptococcus tests studies</h5><p>The two studies that assessed Group A Streptococcus tests were considered to be at high risk of bias according to reviewers’ judgements, due to high risk of selection bias (lack of allocation concealment in both studies and inadequate sequence generation in one study) and high risk for ‘other bias’ (<a href="#niceng237er2.app9">Appendix 9</a>).<a class="bibr" href="#niceng237er2.ref39" rid="niceng237er2.ref39"><sup>39</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref40" rid="niceng237er2.ref40"><sup>40</sup></a> In addition, one study was at high risk of bias due to lack of blinding of participants and personnel.<a class="bibr" href="#niceng237er2.ref39" rid="niceng237er2.ref39"><sup>39</sup></a></p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng237er2tab5"><a href="/books/NBK598986/table/niceng237er2.tab5/?report=objectonly" target="object" title="Table 5" class="img_link icnblk_img figpopup" rid-figpopup="figniceng237er2tab5" rid-ob="figobniceng237er2tab5"><img class="small-thumb" src="/books/NBK598986/table/niceng237er2.tab5/?report=thumb" src-large="/books/NBK598986/table/niceng237er2.tab5/?report=previmg" alt="Table 5. Characteriscs of included studies for Group A Streptococcus tests." /></a><div class="icnblk_cntnt"><h4 id="niceng237er2.tab5"><a href="/books/NBK598986/table/niceng237er2.tab5/?report=objectonly" target="object" rid-ob="figobniceng237er2tab5">Table 5</a></h4><p class="float-caption no_bottom_margin">Characteriscs of included studies for Group A Streptococcus tests. </p></div></div></div><div id="niceng237er2.s4.1.4.2"><h5>4.1.4.2. Hospital admission (immediately after triage or at 28 days)</h5><p>No eligible evidence was identified for this outcome.</p></div><div id="niceng237er2.s4.1.4.3"><h5>4.1.4.3. Escalation of care (some time after initial consultation): Re-consultation/appointment</h5><p>No eligible evidence was identified for this outcome.</p></div><div id="niceng237er2.s4.1.4.4"><h5>4.1.4.4. Escalation of care (some time after initial consultation): Virtual Ward</h5><p>No eligible evidence was identified for this outcome.</p></div><div id="niceng237er2.s4.1.4.5"><h5>4.1.4.5. Escalation of care (some time after initial consultation): Emergency department visit</h5><p>No eligible evidence was identified for this outcome.</p></div><div id="niceng237er2.s4.1.4.6"><h5>4.1.4.6. Escalation of care (some time after initial consultation): Unplanned hospital admission</h5><p>No eligible evidence was identified for this outcome.</p></div><div id="niceng237er2.s4.1.4.7"><h5>4.1.4.7. Hospital length of stay</h5><p>No eligible evidence was identified for this outcome.</p></div><div id="niceng237er2.s4.1.4.8"><h5>4.1.4.8. Follow-up consultation/ongoing monitoring</h5><p>No eligible evidence was identified for this outcome.</p></div><div id="niceng237er2.s4.1.4.9"><h5>4.1.4.9. Antibiotic/antiviral use</h5><p>Two cluster-RCTs found that antibiotic prescriptions were substantially lower in the RADT group compared to usual care group at the index consultation: 43.8% in the RADT group versus 64.1% in the usual care group; p<0.001 (1 cluster-RCT, n=543)<a class="bibr" href="#niceng237er2.ref39" rid="niceng237er2.ref39"><sup>39</sup></a> and 26.7% in the RADT group versus 58.2% in the usual care group; p<0.001 (1 cluster-RCT, n=261) (<a class="figpopup" href="/books/NBK598986/table/niceng237er2.tab6/?report=objectonly" target="object" rid-figpopup="figniceng237er2tab6" rid-ob="figobniceng237er2tab6">Table 6</a>).<a class="bibr" href="#niceng237er2.ref40" rid="niceng237er2.ref40"><sup>40</sup></a> Neither trial reported data allowing for adjustment of sample sizes for clustering effect.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng237er2tab6"><a href="/books/NBK598986/table/niceng237er2.tab6/?report=objectonly" target="object" title="Table 6" class="img_link icnblk_img figpopup" rid-figpopup="figniceng237er2tab6" rid-ob="figobniceng237er2tab6"><img class="small-thumb" src="/books/NBK598986/table/niceng237er2.tab6/?report=thumb" src-large="/books/NBK598986/table/niceng237er2.tab6/?report=previmg" alt="Table 6. Rapid angen detecon test versus usual care - Anbioc prescripons at index consultaon." /></a><div class="icnblk_cntnt"><h4 id="niceng237er2.tab6"><a href="/books/NBK598986/table/niceng237er2.tab6/?report=objectonly" target="object" rid-ob="figobniceng237er2tab6">Table 6</a></h4><p class="float-caption no_bottom_margin">Rapid angen detecon test versus usual care - Anbioc prescripons at index consultaon. </p></div></div></div><div id="niceng237er2.s4.1.4.10"><h5>4.1.4.10. Time to clinical cure/resolution of symptoms</h5><p>No eligible evidence was identified for this outcome.</p></div><div id="niceng237er2.s4.1.4.11"><h5>4.1.4.11. Mortality</h5><p>No eligible evidence was identified for this outcome.</p></div><div id="niceng237er2.s4.1.4.12"><h5>4.1.4.12. HRQoL</h5><p>No eligible evidence was identified for this outcome.</p></div></div><div id="niceng237er2.s4.1.5"><h4>4.1.5. Rapid antigen test – Influenza tests</h4><p>One RCT (n= 93) conducted in Switzerland in 2015 assessed the effects of an influenza RADT in adults with an influenza-like illness after returning from a trip abroad (<a class="figpopup" href="/books/NBK598986/table/niceng237er2.tab7/?report=objectonly" target="object" rid-figpopup="figniceng237er2tab7" rid-ob="figobniceng237er2tab7">Table 7</a> and <a href="#niceng237er2.app6">Appendix 6</a>). The test used, BD Directigen<sup>TM</sup> Flu A + B rapid test, is not currently available in the UK.<a class="bibr" href="#niceng237er2.ref41" rid="niceng237er2.ref41"><sup>41</sup></a></p><p>The source of funding was not reported. The trial was terminated early due to low sensitivity of the intervention.</p><div id="niceng237er2.s4.1.5.1"><h5>4.1.5.1. Risk of bias in included study of influenza tests</h5><p>The single study assessing an influenza test<a class="bibr" href="#niceng237er2.ref41" rid="niceng237er2.ref41"><sup>41</sup></a> was judged by reviewers to be at high risk of bias due to selection bias (limitations in methods used for random sequence generation and allocation concealment), the lack of blinding of participants and personnel, and high risk due to ‘other bias’ (<a href="#niceng237er2.app9">Appendix 9</a>).</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng237er2tab7"><a href="/books/NBK598986/table/niceng237er2.tab7/?report=objectonly" target="object" title="Table 7" class="img_link icnblk_img figpopup" rid-figpopup="figniceng237er2tab7" rid-ob="figobniceng237er2tab7"><img class="small-thumb" src="/books/NBK598986/table/niceng237er2.tab7/?report=thumb" src-large="/books/NBK598986/table/niceng237er2.tab7/?report=previmg" alt="Table 7. Characteriscs of included study for Influenza tests." /></a><div class="icnblk_cntnt"><h4 id="niceng237er2.tab7"><a href="/books/NBK598986/table/niceng237er2.tab7/?report=objectonly" target="object" rid-ob="figobniceng237er2tab7">Table 7</a></h4><p class="float-caption no_bottom_margin">Characteriscs of included study for Influenza tests. </p></div></div></div><div id="niceng237er2.s4.1.5.2"><h5>4.1.5.2. Hospital admission (immediately after triage or at 28 days)</h5><p>No eligible evidence was identified for this outcome.</p></div><div id="niceng237er2.s4.1.5.3"><h5>4.1.5.3. Escalation of care (some time after initial consultation): Re-consultation/appointment</h5><p>No eligible evidence was identified for this outcome.</p></div><div id="niceng237er2.s4.1.5.4"><h5>4.1.5.4. Escalation of care (some time after initial consultation): Virtual Ward</h5><p>No eligible evidence was identified for this outcome.</p></div><div id="niceng237er2.s4.1.5.5"><h5>4.1.5.5. Escalation of care (some time after initial consultation): Emergency department visit</h5><p>No eligible evidence was identified for this outcome.</p></div><div id="niceng237er2.s4.1.5.6"><h5>4.1.5.6. Escalation of care (some time after initial consultation): Unplanned hospital admission</h5><p>No eligible evidence was identified for this outcome.</p></div><div id="niceng237er2.s4.1.5.7"><h5>4.1.5.7. Hospital length of stay</h5><p>No eligible evidence was identified for this outcome.</p></div><div id="niceng237er2.s4.1.5.8"><h5>4.1.5.8. Follow-up consultation/ongoing monitoring</h5><p>No eligible evidence was identified for this outcome.</p></div><div id="niceng237er2.s4.1.5.9"><h5>4.1.5.9. Antibiotic/antiviral use</h5><p>No significant difference was found between RADT and usual care in the number of adults prescribed antibiotics: 23.3% in the RADT group versus 39.4% in the usual care group; p=0.15 (1 RCT, n=93).<a class="bibr" href="#niceng237er2.ref41" rid="niceng237er2.ref41"><sup>41</sup></a> No patient received antiviral treatment.</p></div><div id="niceng237er2.s4.1.5.10"><h5>4.1.5.10. Time to clinical cure/resolution of symptoms</h5><p>No eligible evidence was identified for this outcome.</p></div><div id="niceng237er2.s4.1.5.11"><h5>4.1.5.11. Mortality</h5><p>No deaths occurred in the RADT group (0/60) or usual care group (0/33) (1 RCT, n=93; very low certainty evidence).<a class="bibr" href="#niceng237er2.ref41" rid="niceng237er2.ref41"><sup>41</sup></a>.</p></div><div id="niceng237er2.s4.1.5.12"><h5>4.1.5.12. HRQoL</h5><p>No eligible evidence was identified for this outcome.</p></div></div><div id="niceng237er2.s4.1.6"><h4>4.1.6. GRADE</h4><p><a href="#niceng237er2.app10">Appendix 10</a> provides the GRADE summary of the overall evidence for the included tests.</p></div></div><div id="niceng237er2.s4.2"><h3>4.2. Cost effectiveness review results</h3><div id="niceng237er2.s4.2.1"><h4>4.2.1. Search Results</h4><p>The titles and abstracts of 1,600 records were screened, of which 77 records were identified as potentially meeting the eligibility criteria and were identified for full text review. The full text for one record<a class="bibr" href="#niceng237er2.ref43" rid="niceng237er2.ref43"><sup>43</sup></a> could not be retrieved by our library, but we are confident that it is highly unlikely to be relevant given that the title indicates it is an erratum to a previous paper and the page numbers suggest it is just one page long, and thus unlikely to report a full economic evaluation. The reasons for exclusion at full text stage are described in <a class="figpopup" href="/books/NBK598986/figure/niceng237er2.fig6/?report=objectonly" target="object" rid-figpopup="figniceng237er2fig6" rid-ob="figobniceng237er2fig6">Figure 6</a>, with the full references and reasons available in <a href="#niceng237er2.app13">Appendix 13</a>.</p><div class="iconblock whole_rhythm clearfix ten_col fig" id="figniceng237er2fig6" co-legend-rid="figlgndniceng237er2fig6"><a href="/books/NBK598986/figure/niceng237er2.fig6/?report=objectonly" target="object" title="Figure 6" class="img_link icnblk_img figpopup" rid-figpopup="figniceng237er2fig6" rid-ob="figobniceng237er2fig6"><img class="small-thumb" src="/books/NBK598986/bin/niceng237er2f6.gif" src-large="/books/NBK598986/bin/niceng237er2f6.jpg" alt="Figure 6. PRISMA flowchart for the selection of systematic reviews and cost utility studies." /></a><div class="icnblk_cntnt" id="figlgndniceng237er2fig6"><h4 id="niceng237er2.fig6"><a href="/books/NBK598986/figure/niceng237er2.fig6/?report=objectonly" target="object" rid-ob="figobniceng237er2fig6">Figure 6</a></h4><p class="float-caption no_bottom_margin">PRISMA flowchart for the selection of systematic reviews and cost utility studies. </p></div></div><p>No eligible additional references were identified through examining reference lists.</p><p>Two systematic reviews<a class="bibr" href="#niceng237er2.ref20" rid="niceng237er2.ref20"><sup>20</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref44" rid="niceng237er2.ref44"><sup>44</sup></a> and 16 individual cost-utility studies<a class="bibr" href="#niceng237er2.ref34" rid="niceng237er2.ref34"><sup>34</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref45" rid="niceng237er2.ref45"><sup>45</sup></a><sup>–</sup><a class="bibr" href="#niceng237er2.ref59" rid="niceng237er2.ref59"><sup>59</sup></a> met the pre-defined the eligibility criteria (<a class="figpopup" href="/books/NBK598986/figure/niceng237er2.fig6/?report=objectonly" target="object" rid-figpopup="figniceng237er2fig6" rid-ob="figobniceng237er2fig6">Figure 6</a>).</p></div><div id="niceng237er2.s4.2.2"><h4>4.2.2. Narrative summary, appraisal and applicability – Systematic Reviews</h4><p>Two potentially relevant systematic reviews were identified.<a class="bibr" href="#niceng237er2.ref20" rid="niceng237er2.ref20"><sup>20</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref44" rid="niceng237er2.ref44"><sup>44</sup></a> Here we briefly summarise each review, focusing largely on whether these reviews are likely to have captured all the cost utility studies relevant to our review question.</p><p>
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<b>Van der Pol 2021</b>
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</p><p>The main objective of this review<a class="bibr" href="#niceng237er2.ref20" rid="niceng237er2.ref20"><sup>20</sup></a> was ‘to review the methods used in economic evaluations of applied diagnostic techniques, for all patients seeking care for infectious diseases of the respiratory tract’. The searches were limited to articles published between January 2000 and May 2020. The review included cost-effectiveness analyses, cost-utility analyses and cost-minimisation analyses, as long as patient-relevant outcomes were included. Diagnostic strategies were defined as “identifying the most likely cause of, and optionally optimal treatment for, a previously undetected disease in a clinically suspect patient who is seeking care”. Of the 70 studies included in the review, 23 evaluated rapid diagnostic tests, which included rapid influenza tests, C-reactive protein tests and procalcitonin tests. Other strategies evaluated included traditional diagnostics (n=26), Xpert (n=19) and clinical rules (n=9).</p><p>The quality of the review was assessed using a critical appraisal checklist (for full details see <a href="#niceng237er2.app12">Appendix 12</a>). The key issues identified were that 1) the search strategy used terms which are likely to be inconsistently used in the literature e.g. “diagnostic” and was limited in breadth, 2) the grey literature was not searched, 3) the CHEERS checklist<a class="bibr" href="#niceng237er2.ref60" rid="niceng237er2.ref60"><sup>60</sup></a> was used to create a quality score for the included studies, but this is a reporting checklist rather than a quality appraisal tool, and 4) only 10% of the data extraction was done by two independent reviewers.</p><p>Data extraction focused on the methodology used in each economic evaluation, in line with the objective of the review. Data relating to study results were not extracted. Given the different review objective, the wider scope and the issues identified through the quality assessment, it was decided that this review is a useful source of relevant cost utility studies, but the review itself could not be used in isolation to answer our review question. The findings of the Van der Pol review do however provide useful and very relevant discussion about the methodological strengths and limitations of cost-effectiveness research in this area, which we will refer to heavily in the discussion of this report.<a class="bibr" href="#niceng237er2.ref20" rid="niceng237er2.ref20"><sup>20</sup></a></p><p>
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<b>Wubishet 2022</b>
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</p><p>The main objective of the Wubishet 2022 review<a class="bibr" href="#niceng237er2.ref44" rid="niceng237er2.ref44"><sup>44</sup></a> was to summarise and critically appraise the quality of published economic evaluations focused on interventions which promote antimicrobial stewardship or aim to reduce inappropriate antimicrobial prescribing in primary care. Full or partial economic evaluations of one or more antimicrobial stewardship intervention evaluated in a primary care setting were included. There were no restrictions on the type of intervention evaluated, the study population or the type of infection under consideration, or the comparator. Twelve studies were included in the review; 10 of which focused on inappropriate prescribing for upper/lower/acute respiratory tract infection. Six of the included studies focused on adults specifically, with a further 4 studies including both children and adults in their evaluation. Six of the included studies evaluated a strategy which involved the use of POC CRP testing.</p><p>The quality of the review was assessed using a critical appraisal checklist (for full details see <a href="#niceng237er2.app12">Appendix 12</a>). The key issues identified were 1) the inclusion and exclusion criteria for the review were not clearly stated, 2) the search strategy was very limited, particularly with regards to the terms relating to the intervention, 3) it was unclear whether the critical appraisal had been done in duplicate, 4) the discussion in the review did not discuss the implications of the results on future practice/policy.</p><p>The data extraction focused on the methods used in each study and the findings of each study. Given the different review objective, the different (albeit overlapping) target interventions and the issues identified through the quality assessment, it was decided that this review is a useful source of relevant cost-utility studies, but the review itself could not be used in isolation to answer our review question.</p></div><div id="niceng237er2.s4.2.3"><h4>4.2.3. Cost utility studies – study characteristics</h4><p>The references for the included studies in the two systematic reviews were checked against our search results to ensure we have captured all relevant studies in our searches for cost utility studies. Our search identified all of the relevant (i.e. cost utility studies) in the Van der Pol 2021 review.<a class="bibr" href="#niceng237er2.ref20" rid="niceng237er2.ref20"><sup>20</sup></a> There were also no additional relevant studies from those included in the Wubishet 2022 review.<a class="bibr" href="#niceng237er2.ref44" rid="niceng237er2.ref44"><sup>44</sup></a></p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng237er2tab8"><a href="/books/NBK598986/table/niceng237er2.tab8/?report=objectonly" target="object" title="Table 8" class="img_link icnblk_img figpopup" rid-figpopup="figniceng237er2tab8" rid-ob="figobniceng237er2tab8"><img class="small-thumb" src="/books/NBK598986/table/niceng237er2.tab8/?report=thumb" src-large="/books/NBK598986/table/niceng237er2.tab8/?report=previmg" alt="Table 8. Characteriscs of included cost ulity studies." /></a><div class="icnblk_cntnt"><h4 id="niceng237er2.tab8"><a href="/books/NBK598986/table/niceng237er2.tab8/?report=objectonly" target="object" rid-ob="figobniceng237er2tab8">Table 8</a></h4><p class="float-caption no_bottom_margin">Characteriscs of included cost ulity studies. </p></div></div><p>Details of the study characteristics for all 16 included cost utility studies can be found in <a class="figpopup" href="/books/NBK598986/table/niceng237er2.tab8/?report=objectonly" target="object" rid-figpopup="figniceng237er2tab8" rid-ob="figobniceng237er2tab8">Table 8</a>. Three of the included cost-utility studies were economic evaluations conducted alongside randomised controlled trials.<a class="bibr" href="#niceng237er2.ref34" rid="niceng237er2.ref34"><sup>34</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref50" rid="niceng237er2.ref50"><sup>50</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref54" rid="niceng237er2.ref54"><sup>54</sup></a>. The majority of the remaining studies were model-based evaluations, 11 of which were decision trees,<a class="bibr" href="#niceng237er2.ref45" rid="niceng237er2.ref45"><sup>45</sup></a><sup>–</sup><a class="bibr" href="#niceng237er2.ref48" rid="niceng237er2.ref48"><sup>48</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref51" rid="niceng237er2.ref51"><sup>51</sup></a><sup>–</sup><a class="bibr" href="#niceng237er2.ref53" rid="niceng237er2.ref53"><sup>53</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref56" rid="niceng237er2.ref56"><sup>56</sup></a><sup>–</sup><a class="bibr" href="#niceng237er2.ref59" rid="niceng237er2.ref59"><sup>59</sup></a> and one study used a combination of a decision tree to capture the short-term diagnostic pathway and a Markov model to capture longer term outcomes and costs.<a class="bibr" href="#niceng237er2.ref49" rid="niceng237er2.ref49"><sup>49</sup></a> One study was an economic evaluation based on an observational study.<a class="bibr" href="#niceng237er2.ref55" rid="niceng237er2.ref55"><sup>55</sup></a> The majority of the studies selected a relatively short time horizon to estimate costs and consequences, four studies adopted a time horizon of 28 days,<a class="bibr" href="#niceng237er2.ref48" rid="niceng237er2.ref48"><sup>48</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref50" rid="niceng237er2.ref50"><sup>50</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref54" rid="niceng237er2.ref54"><sup>54</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref55" rid="niceng237er2.ref55"><sup>55</sup></a> and two stated that an episode of illness or treatment episode was the time horizon. One study reported a model which had been developed using data largely from a trial, Cals 2013,<a class="bibr" href="#niceng237er2.ref35" rid="niceng237er2.ref35"><sup>35</sup></a> with 3 years follow-up.<a class="bibr" href="#niceng237er2.ref49" rid="niceng237er2.ref49"><sup>49</sup></a></p><p>Seven of the included evaluations were for a UK/England and Wales setting, with a further six developed for a US setting and one in each of Hong Kong, Sweden/Norway, Canada and Thailand. The economic evaluations focused on patients presenting at a range of settings, with many studies (n=7/16) focusing solely or partially on primary care.<a class="bibr" href="#niceng237er2.ref34" rid="niceng237er2.ref34"><sup>34</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref46" rid="niceng237er2.ref46"><sup>46</sup></a><sup>–</sup><a class="bibr" href="#niceng237er2.ref50" rid="niceng237er2.ref50"><sup>50</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref55" rid="niceng237er2.ref55"><sup>55</sup></a> There were a further six studies conducted for a US population where the setting was not clearly stated, but looked likely to be focused on a primary care setting.<a class="bibr" href="#niceng237er2.ref45" rid="niceng237er2.ref45"><sup>45</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref53" rid="niceng237er2.ref53"><sup>53</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref56" rid="niceng237er2.ref56"><sup>56</sup></a><sup>–</sup><a class="bibr" href="#niceng237er2.ref58" rid="niceng237er2.ref58"><sup>58</sup></a> Five studies focused their evaluation either solely or partially on a secondary care setting, including ambulatory care, outpatient, or emergency departments.<a class="bibr" href="#niceng237er2.ref47" rid="niceng237er2.ref47"><sup>47</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref51" rid="niceng237er2.ref51"><sup>51</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref52" rid="niceng237er2.ref52"><sup>52</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref54" rid="niceng237er2.ref54"><sup>54</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref59" rid="niceng237er2.ref59"><sup>59</sup></a></p><p>A wide range of different rapid tests were evaluated, the most common of which being POCT for CRP (n=4/17),<a class="bibr" href="#niceng237er2.ref34" rid="niceng237er2.ref34"><sup>34</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref48" rid="niceng237er2.ref48"><sup>48</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref49" rid="niceng237er2.ref49"><sup>49</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref55" rid="niceng237er2.ref55"><sup>55</sup></a> and rapid tests for influenza (n=5/17).<a class="bibr" href="#niceng237er2.ref54" rid="niceng237er2.ref54"><sup>54</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref56" rid="niceng237er2.ref56"><sup>56</sup></a><sup>–</sup><a class="bibr" href="#niceng237er2.ref59" rid="niceng237er2.ref59"><sup>59</sup></a> A range of different comparators were used across the evaluations, with standard care being the most commonly included.</p><p>Six of the included studies evaluated rapid tests for influenza.<a class="bibr" href="#niceng237er2.ref51" rid="niceng237er2.ref51"><sup>51</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref54" rid="niceng237er2.ref54"><sup>54</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref56" rid="niceng237er2.ref56"><sup>56</sup></a><sup>–</sup><a class="bibr" href="#niceng237er2.ref59" rid="niceng237er2.ref59"><sup>59</sup></a> Three of these studies were conducted for a US population and the focus was mainly on evaluating different antiviral treatments rather than the use of rapid testing (although rapid testing vs. no rapid testing was included as a comparator)<a class="bibr" href="#niceng237er2.ref56" rid="niceng237er2.ref56"><sup>56</sup></a><sup>–</sup><a class="bibr" href="#niceng237er2.ref58" rid="niceng237er2.ref58"><sup>58</sup></a>. Nicholson 2014 evaluated multiple tests (rapid molecular and near-patient diagnostic tests for influenza, respiratory syncytial virus (RSV) and Streptococcus pneumoniae infections) in a UK RCT to evaluate the impact on prescribing and clinical outcomes and cost-effectiveness.<a class="bibr" href="#niceng237er2.ref54" rid="niceng237er2.ref54"><sup>54</sup></a></p><p>Four of the included studies focused on the use of rapid tests to manage individuals presenting with symptoms suggestive of Group A streptococcus pharyngitis (GAS).<a class="bibr" href="#niceng237er2.ref45" rid="niceng237er2.ref45"><sup>45</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref47" rid="niceng237er2.ref47"><sup>47</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref50" rid="niceng237er2.ref50"><sup>50</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref53" rid="niceng237er2.ref53"><sup>53</sup></a>. One of these studies was a model, developed for a UK NHS and Personal Social Services perspective, informed by an extensive systematic review of the evidence (diagnostic accuracy, clinical effectiveness and economic evaluations) for 21 different point of care tests for detecting group A Streptococcus bacteria (14 of these tests featured in the economic evaluation).<a class="bibr" href="#niceng237er2.ref47" rid="niceng237er2.ref47"><sup>47</sup></a> Another of these studies was an economic evaluation alongside an RCT conducted in the UK.<a class="bibr" href="#niceng237er2.ref50" rid="niceng237er2.ref50"><sup>50</sup></a></p><p>One of the included studies focused specifically on a sub-group of patients, those who are diagnosed COPD and experiencing an exacerbation.<a class="bibr" href="#niceng237er2.ref34" rid="niceng237er2.ref34"><sup>34</sup></a> This study was an economic evaluation conducted alongside a RCT<a class="bibr" href="#niceng237er2.ref34" rid="niceng237er2.ref34"><sup>34</sup></a>.</p></div><div id="niceng237er2.s4.2.4"><h4>4.2.4. Cost utility studies – applicability</h4><p>The applicability of the included studies was assessed using the first section of the NICE appraisal checklist for economic evaluations (see <a href="#niceng237er2.app14">Appendix 14</a> for details).<a class="bibr" href="#niceng237er2.ref23" rid="niceng237er2.ref23"><sup>23</sup></a></p><p>Six of the included studies were judged to be directly applicable to our review question, four of which evaluated the cost-effectiveness of POC CRP.<a class="bibr" href="#niceng237er2.ref34" rid="niceng237er2.ref34"><sup>34</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref47" rid="niceng237er2.ref47"><sup>47</sup></a><sup>–</sup><a class="bibr" href="#niceng237er2.ref49" rid="niceng237er2.ref49"><sup>49</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref54" rid="niceng237er2.ref54"><sup>54</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref55" rid="niceng237er2.ref55"><sup>55</sup></a> Fraser 2020 undertook an extensive systematic review of the evidence of 21 different point of care tests for Group A streptococcus.<a class="bibr" href="#niceng237er2.ref47" rid="niceng237er2.ref47"><sup>47</sup></a> Nicholson 2014 evaluated rapid near-patient tests for Influenza A and B and pneumococcal infection.<a class="bibr" href="#niceng237er2.ref54" rid="niceng237er2.ref54"><sup>54</sup></a></p><p>Two studies were judged to be partially applicable to our review question.<a class="bibr" href="#niceng237er2.ref50" rid="niceng237er2.ref50"><sup>50</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref52" rid="niceng237er2.ref52"><sup>52</sup></a> Little 2014 is an RCT-based economic evaluation focused on a rapid test for A/C/G streptococci in conjunction with the FeverPAIN clinical scoring algorithm.<a class="bibr" href="#niceng237er2.ref50" rid="niceng237er2.ref50"><sup>50</sup></a> The trial included both adults and children which deviates from our review question, but the results may still be relevant. Michaelidis 2012 evaluated the cost-effectiveness of point of care procalcitonin (POC PCT) in a US outpatient setting from a healthcare system perspective.<a class="bibr" href="#niceng237er2.ref52" rid="niceng237er2.ref52"><sup>52</sup></a> Despite the difference in country, as the only economic evaluation focused on this test in a relevant setting to our review question, we assessed this study as potentially providing some useful evidence.</p><p>The remaining studies were scored as being not applicable to our review question.<a class="bibr" href="#niceng237er2.ref45" rid="niceng237er2.ref45"><sup>45</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref46" rid="niceng237er2.ref46"><sup>46</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref51" rid="niceng237er2.ref51"><sup>51</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref53" rid="niceng237er2.ref53"><sup>53</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref56" rid="niceng237er2.ref56"><sup>56</sup></a><sup>–</sup><a class="bibr" href="#niceng237er2.ref59" rid="niceng237er2.ref59"><sup>59</sup></a> These studies were all focused on non-UK settings.</p></div></div><div id="niceng237er2.s4.3"><h3>4.3. Results of included cost utility studies</h3><p>The main results of the included cost utility studies are presented in <a class="figpopup" href="/books/NBK598986/table/niceng237er2.tab9/?report=objectonly" target="object" rid-figpopup="figniceng237er2tab9" rid-ob="figobniceng237er2tab9">Table 9</a>. Here we will focus on the studies assessed as being either directly or partially applicable to our review question.</p><p>Three directly applicable studies evaluated the cost-effectiveness of POC CRP in patients presenting to primary care with symptoms suggestive of ARI. All studies found POC CRP to be cost-effective.<a class="bibr" href="#niceng237er2.ref48" rid="niceng237er2.ref48"><sup>48</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref49" rid="niceng237er2.ref49"><sup>49</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref55" rid="niceng237er2.ref55"><sup>55</sup></a> Despite being cost-effective, Oppoing 2013 warned about the potential resource implications of widespread use. Holmes 2018 addresses this issue in their evaluation by comparing POC CRP testing and treatment in line with NICE CG191 clinical recommendations i.e. test only when clinical assessment is not conclusive and do not routinely offer antibiotics if CRP is <20mg/L, and offer a delayed prescription if CRP is between 20-100mg/L, compared to pragmatic use of POC CRP.<a class="bibr" href="#niceng237er2.ref61" rid="niceng237er2.ref61"><sup>61</sup></a> They found that allowing POC CRP to be used pragmatically in primary care led to it being borderline cost-effective, but by adhering to guidelines around usage, the model predicted a far lower incremental cost-effectiveness ratio. A further study evaluated POC CRP specifically in patients experiencing a COPD exacerbation and found that POC CRP was cost-effective at a willingness to pay threshold £20,000 per QALY.<a class="bibr" href="#niceng237er2.ref34" rid="niceng237er2.ref34"><sup>34</sup></a></p><p>Michaelidis 2014 conducted a model-based economic evaluation of POC PCT, concluding that POC PCT could be cost-effective if the cost of antimicrobial resistance is factored into the analysis and if the test is only used in those judged to require antibiotics. The authors attempt to estimate the cost of antibiotic resistance per antibiotic prescribed for outpatient management of ARI in adults, but in the absence of methodological guidance on this issue, the validity of these estimates is unclear.<a class="bibr" href="#niceng237er2.ref52" rid="niceng237er2.ref52"><sup>52</sup></a></p><p>Fraser 2020 evaluated 14 different point of care (POC) tests for Group A streptococcus (GAS) and found that none of the POC tests evaluated were cost-effective compared with usual care in both a primary care and secondary setting.<a class="bibr" href="#niceng237er2.ref47" rid="niceng237er2.ref47"><sup>47</sup></a> Little 2014 conducted an RCT-based economic evaluation of a rapid antigen test (IMI TestPack Plus Strep A, Inverness Medical, Bedford, UK) for A/C/G streptococci and concluded that the use of a clinical algorithm alone is most likely to be cost-effective compared to using the rapid test in combination with the clinical algorithm.</p><p>Nicholson 2014 evaluated two POCTs (Quidel for influenza, and BinaxNOW for the pneumococcal antigen) in an RCT compared to laboratory-based PCR and traditional culture/serology and found that, although the POCTs had the highest gain in terms of QALYs, it did not fall below a cost-effectiveness threshold of £30,000 compared to laboratory-based PCR.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng237er2tab9"><a href="/books/NBK598986/table/niceng237er2.tab9/?report=objectonly" target="object" title="Table 9" class="img_link icnblk_img figpopup" rid-figpopup="figniceng237er2tab9" rid-ob="figobniceng237er2tab9"><img class="small-thumb" src="/books/NBK598986/table/niceng237er2.tab9/?report=thumb" src-large="/books/NBK598986/table/niceng237er2.tab9/?report=previmg" alt="Table 9. Data extracon for cost-ulity studies - results." /></a><div class="icnblk_cntnt"><h4 id="niceng237er2.tab9"><a href="/books/NBK598986/table/niceng237er2.tab9/?report=objectonly" target="object" rid-ob="figobniceng237er2tab9">Table 9</a></h4><p class="float-caption no_bottom_margin">Data extracon for cost-ulity studies - results. </p></div></div></div><div id="niceng237er2.s4.4"><h3>4.4. Critical appraisal of included cost utility studies</h3><p>The results of the critical appraisal using the Drummond 2015 checklist<a class="bibr" href="#niceng237er2.ref22" rid="niceng237er2.ref22"><sup>22</sup></a> can be found in <a class="figpopup" href="/books/NBK598986/table/niceng237er2.tab10/?report=objectonly" target="object" rid-figpopup="figniceng237er2tab10" rid-ob="figobniceng237er2tab10">Table 10</a>. We adapted question 4 of the appraisal tool slightly (Were all the important and relevant costs and consequences for each alternative identified?) to allow us to answer this question separately for short-term, long-term and antimicrobial resistance-related costs separately. We felt this was important additional detail for these studies given that the majority had a short-term time horizon.</p><p>The short time horizon of many of the studies was consistently highlighted as a limitation, specifically the lack of robust data to inform longer-term projections. Despite concluding that POC CRP is cost-effective, three of the four economic evaluations focused on this test were limited to capturing short-term costs and consequences.<a class="bibr" href="#niceng237er2.ref34" rid="niceng237er2.ref34"><sup>34</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref48" rid="niceng237er2.ref48"><sup>48</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref55" rid="niceng237er2.ref55"><sup>55</sup></a> Hunter 2015 however did base their analysis of POC CRP on longer-term (3 year) data from an RCT and also found it to be cost-effective.<a class="bibr" href="#niceng237er2.ref49" rid="niceng237er2.ref49"><sup>49</sup></a></p><p>A key motivation for rapid testing is to reduce future antimicrobial resistance (AMR) associated with unnecessary antibiotic prescribing to limit, yet there is no standardised, recommended methodology for estimating the costs and consequences associated with AMR in an economic evaluation. Logically, this is an oversight of a key potential benefit, both in terms of reducing long-term costs and improving patient outcomes (or avoiding patient harm). Two studies did make some attempt to incorporate an estimated cost associated with AMR into their sensitivity analyses, but the validity of their calculations was unclear.<a class="bibr" href="#niceng237er2.ref46" rid="niceng237er2.ref46"><sup>46</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref48" rid="niceng237er2.ref48"><sup>48</sup></a>.</p><p>Another key potential benefit or harm of rapid, point of care testing is the potential effect it has on patient behaviour over time. Patients may be discouraged from attending their GP in future, having received a POC CRP if they feel they are less likely to be prescribed antibiotics. Conversely, the ability to get a ‘quick answer’ may actually result in more patients with ARI symptoms attending their GP over time. Cals et al. (2013), a pragmatic cluster-randomised trial, is the only trial in the UK with long enough follow-up and the appropriate study design to assess this longer-term implication.<a class="bibr" href="#niceng237er2.ref35" rid="niceng237er2.ref35"><sup>35</sup></a> Although the mean number of episodes of respiratory tract infections during follow-up was lower for the POC CRP arm compared to no CRP, the difference was not statistically significant. Hunter et al. (2015) was the only study to incorporate this data into their evaluation, and rightly noted that any harms associated with reduced attendance will not have been captured in their analysis.<a class="bibr" href="#niceng237er2.ref49" rid="niceng237er2.ref49"><sup>49</sup></a></p><p>Many of the other studies lacked robust underpinning evidence on effectiveness. Adjustment for differential timing was rarely an applicable problem for these studies due to the short-term nature (1 year or less) of most evaluations.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng237er2tab10"><a href="/books/NBK598986/table/niceng237er2.tab10/?report=objectonly" target="object" title="Table 10" class="img_link icnblk_img figpopup" rid-figpopup="figniceng237er2tab10" rid-ob="figobniceng237er2tab10"><img class="small-thumb" src="/books/NBK598986/table/niceng237er2.tab10/?report=thumb" src-large="/books/NBK598986/table/niceng237er2.tab10/?report=previmg" alt="Table 10. Crical appraisal of included cost ulity studies." /></a><div class="icnblk_cntnt"><h4 id="niceng237er2.tab10"><a href="/books/NBK598986/table/niceng237er2.tab10/?report=objectonly" target="object" rid-ob="figobniceng237er2tab10">Table 10</a></h4><p class="float-caption no_bottom_margin">Crical appraisal of included cost ulity studies. </p></div></div></div></div><div id="niceng237er2.rl.r1"><h2 id="_niceng237er2_rl_r1_">5. References</h2><dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>1.</dt><dd><div class="bk_ref" id="niceng237er2.ref1">NHS England. <em>Combined adult and paediatric Acute Respiratory Infection (ARI) hubs (previously RCAS hubs)</em>. 2022. URL: <a href="https://www.england.nhs.uk/wp-content/uploads/2022/10/BW2064-combined-adult-paediatric-ari-hubs-october-22.pdf" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.england.nhs<wbr style="display:inline-block"></wbr>​.uk/wp-content/uploads<wbr style="display:inline-block"></wbr>​/2022/10/BW2064-combined-adult-paediatric-ari-hubs-october-22.pdf</a> (Accessed 10 June 2023).</div></dd></dl><dl class="bkr_refwrap"><dt>2.</dt><dd><div class="bk_ref" id="niceng237er2.ref2">NHS England and NHS Improvement. <em>Point of care testing in community pharmacies: Guidance for commissioners and community pharmacies delivering NHS services</em>. 2022. URL: <a href="https://www.england.nhs.uk/wp-content/uploads/2022/01/B0722-Point-of-Care-Testing-in-Community-Pharmacies-Guide_January-2022.pdf" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.england.nhs<wbr style="display:inline-block"></wbr>​.uk/wp-content/uploads<wbr style="display:inline-block"></wbr>​/2022/01/B0722-Point-of-Care-Testing-in-Community-Pharmacies-Guide<wbr style="display:inline-block"></wbr>​_January-2022.pdf</a> (Accessed 10 June 2023).</div></dd></dl><dl class="bkr_refwrap"><dt>3.</dt><dd><div class="bk_ref" id="niceng237er2.ref3">Saleh
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MAA, van de Garde
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EMW, van Hasselt
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JGC. Host-response biomarkers for the diagnosis of bacterial respiratory tract infections. <em>Clin Chem Lab Med</em>
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2019;<strong>57</strong>(4):442–51. 10.1515/cclm-2018-0682
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[<a href="https://pubmed.ncbi.nlm.nih.gov/30183665" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30183665</span></a>] [<a href="http://dx.crossref.org/10.1515/cclm-2018-0682" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>4.</dt><dd><div class="bk_ref" id="niceng237er2.ref4">Hoeboer
|
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SH, van der Geest
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PJ, Nieboer
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D, Groeneveld
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AB. The diagnostic accuracy of procalcitonin for bacteraemia: a systematic review and meta-analysis. <em>Clin Microbiol Infect</em>
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2015;<strong>21</strong>(5):474–81. 10.1016/j.cmi.2014.12.026
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[<a href="https://pubmed.ncbi.nlm.nih.gov/25726038" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25726038</span></a>] [<a href="http://dx.crossref.org/10.1016/j.cmi.2014.12.026" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>5.</dt><dd><div class="bk_ref" id="niceng237er2.ref5">Tsao
|
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YT, Tsai
|
|
YH, Liao
|
|
WT, Shen
|
|
CJ, Shen
|
|
CF, Cheng
|
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CM. Differential Markers of Bacterial and Viral Infections in Children for Point-of-Care Testing. <em>Trends Mol Med</em>
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2020;<strong>26</strong>(12):1118–32. 10.1016/j.molmed.2020.09.004
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[<a href="/pmc/articles/PMC7522093/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7522093</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/33008730" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33008730</span></a>] [<a href="http://dx.crossref.org/10.1016/j.molmed.2020.09.004" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>6.</dt><dd><div class="bk_ref" id="niceng237er2.ref6">Hayney
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MS, Henriquez
|
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KM, Barnet
|
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JH, Ewers
|
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T, Champion
|
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HM, Flannery
|
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S, et al. Serum IFN-γ-induced protein 10 (IP-10) as a biomarker for severity of acute respiratory infection in healthy adults. <em>J Clin Virol</em>
|
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2017;<strong>90</strong>:32–7. 10.1016/j.jcv.2017.03.003
|
|
[<a href="/pmc/articles/PMC5408957/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5408957</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28334685" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28334685</span></a>] [<a href="http://dx.crossref.org/10.1016/j.jcv.2017.03.003" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>7.</dt><dd><div class="bk_ref" id="niceng237er2.ref7">Shapiro
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NI, Filbin
|
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MR, Hou
|
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PC, Kurz
|
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MC, Han
|
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JH, Aufderheide
|
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TP, et al. Diagnostic Accuracy of a Bacterial and Viral Biomarker Point-of-Care Test in the Outpatient Setting. <em>JAMA Network Open</em>
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2022;<strong>5</strong>(10):e2234588–e. 10.1001/jamanetworkopen.2022.34588
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[<a href="/pmc/articles/PMC9579916/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9579916</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/36255727" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36255727</span></a>] [<a href="http://dx.crossref.org/10.1001/jamanetworkopen.2022.34588" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>8.</dt><dd><div class="bk_ref" id="niceng237er2.ref8">Vos
|
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LM, Bruning
|
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AHL, Reitsma
|
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JB, Schuurman
|
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R, Riezebos-Brilman
|
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A, Hoepelman
|
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AIM, et al. Rapid Molecular Tests for Influenza, Respiratory Syncytial Virus, and Other Respiratory Viruses: A Systematic Review of Diagnostic Accuracy and Clinical Impact Studies. <em>Clin Infect Dis</em>
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2019;<strong>69</strong>(7):1243–53. 10.1093/cid/ciz056
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[<a href="/pmc/articles/PMC7108200/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7108200</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30689772" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30689772</span></a>] [<a href="http://dx.crossref.org/10.1093/cid/ciz056" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>9.</dt><dd><div class="bk_ref" id="niceng237er2.ref9">Lean
|
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WL, Arnup
|
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S, Danchin
|
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M, Steer
|
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AC. Rapid diagnostic tests for group A streptococcal pharyngitis: a meta-analysis. <em>Pediatrics</em>
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2014;<strong>134</strong>(4):771–81. 10.1542/peds.2014-1094
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[<a href="https://pubmed.ncbi.nlm.nih.gov/25201792" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25201792</span></a>] [<a href="http://dx.crossref.org/10.1542/peds.2014-1094" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>10.</dt><dd><div class="bk_ref" id="niceng237er2.ref10">Kim
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P, Deshpande
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A, Rothberg
|
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MB. Urinary Antigen Testing for Respiratory Infections: Current Perspectives on Utility and Limitations. <em>Infect Drug Resist</em>
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2022;<strong>15</strong>:2219–28. 10.2147/idr.S321168
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[<a href="/pmc/articles/PMC9058651/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9058651</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/35510157" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35510157</span></a>] [<a href="http://dx.crossref.org/10.2147/idr.S321168" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>11.</dt><dd><div class="bk_ref" id="niceng237er2.ref11">SR / MA / HTA / ITC - MEDLINE, Embase, PsycInfo. <em>In</em>. <em>CADTH Search Filters Database</em>. Ottawa: CADTH; 2021. URL: <a href="https://searchfilters.cadth.ca/link/33" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https:<wbr style="display:inline-block"></wbr>​//searchfilters.cadth.ca/link/33</a> (Accessed 23 June 2023).</div></dd></dl><dl class="bkr_refwrap"><dt>12.</dt><dd><div class="bk_ref" id="niceng237er2.ref12">Cochrane. <em>How CENTRAL is created</em>. Cochrane Library; 2023. URL: <a href="https://www.cochranelibrary.com/central/central-creation" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.cochranelibrary<wbr style="display:inline-block"></wbr>​.com/central/central-creation</a> (Accessed 23 June 2023).</div></dd></dl><dl class="bkr_refwrap"><dt>13.</dt><dd><div class="bk_ref" id="niceng237er2.ref13">Lefebvre
|
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C, Glanville
|
|
J, Briscoe
|
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S, Featherstone
|
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R, Littlewood
|
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A, Marshall
|
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C, et al. Chapter 4: Searching for and selecting studies. <em>In:</em>
|
|
Higgins
|
|
JPT, Thomas
|
|
J, Chandler
|
|
J, Cumpston
|
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M, Li
|
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T, Page
|
|
MJ, Welch
|
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VA
|
|
<em>(editors)</em>. <em>Cochrane Handbook for Systematic Reviews of Interventions version 6.3 (updated February 2022)</em>. Cochrane; 2022. URL: <a href="https://training.cochrane.org/handbook/current/chapter-04" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://training<wbr style="display:inline-block"></wbr>​.cochrane<wbr style="display:inline-block"></wbr>​.org/handbook/current/chapter-04</a> (Accessed 26 May 2023).</div></dd></dl><dl class="bkr_refwrap"><dt>14.</dt><dd><div class="bk_ref" id="niceng237er2.ref14">MEDLINE Sensitivity- and precision-maximizing version (2023 revision) for Ovid. <em>In:</em>
|
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<em>Randomized Controlled Trials and Other Trials: Filters</em>. The ISSG Search Filter Resource; 2023. URL: <a href="https://sites.google.com/a/york.ac.uk/issg-search-filters-resource/home/rcts" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://sites<wbr style="display:inline-block"></wbr>​.google<wbr style="display:inline-block"></wbr>​.com/a/york.ac.uk/issg-search-filters-resource/home/rcts</a> (Accessed 26 May 2023).</div></dd></dl><dl class="bkr_refwrap"><dt>15.</dt><dd><div class="bk_ref" id="niceng237er2.ref15">Glanville
|
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J. <em>Embase RCT filter for Ovid: 30 April 2023 revision</em>. The ISSG Search Filter Resource; 2023. URL: <a href="https://sites.google.com/a/york.ac.uk/issg-search-filters-resource/home/rcts/embase-rct-filter#h.ge0knbymsrdx" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://sites<wbr style="display:inline-block"></wbr>​.google<wbr style="display:inline-block"></wbr>​.com/a/york.ac.uk/issg-search-filters-resource<wbr style="display:inline-block"></wbr>​/home/rcts/embase-rct-filter#h<wbr style="display:inline-block"></wbr>​.ge0knbymsrdx</a> (Accessed 28 May 2023).</div></dd></dl><dl class="bkr_refwrap"><dt>16.</dt><dd><div class="bk_ref" id="niceng237er2.ref16">Smedemark
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SA, Aabenhus
|
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R, Llor
|
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C, Fournaise
|
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A, Olsen
|
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O, Jørgensen
|
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KJ. Biomarkers as point-of-care tests to guide prescription of antibiotics in people with acute respiratory infections in primary care. <em>Cochrane Database Syst Rev</em>
|
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2022(10):CD010130. 10.1002/14651858.CD010130.pub3
|
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[<a href="/pmc/articles/PMC9575154/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9575154</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/36250577" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36250577</span></a>] [<a href="http://dx.crossref.org/10.1002/14651858.CD010130.pub3" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>17.</dt><dd><div class="bk_ref" id="niceng237er2.ref17">Higgins
|
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J, Eldridge
|
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S, Li
|
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Te. Chapter 23: Including variants on randomized trials. In: Higgins
|
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JPT, Thomas
|
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J, Chandler
|
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J, Cumpston
|
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M, Li
|
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T, Page
|
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MJ, Welch
|
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VA
|
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<em>(editors)</em>. <em>Cochrane Handbook for Systematic Reviews of Interventions version 6.3 (updated February 2022)</em>
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2022. <a href="http://www.training.cochrane.org/handbook" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>​.training.cochrane<wbr style="display:inline-block"></wbr>​.org/handbook</a></div></dd></dl><dl class="bkr_refwrap"><dt>18.</dt><dd><div class="bk_ref" id="niceng237er2.ref18">Langan
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D, Higgins
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JPT, Jackson
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D, Bowden
|
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J, Veroniki
|
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AA, Kontopantelis
|
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E, et al. A comparison of heterogeneity variance estimators in simulated random-effects meta-analyses. <em>Res Synth Methods</em>
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2019;<strong>10</strong>(1):83–98. 10.1002/jrsm.1316
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[<a href="https://pubmed.ncbi.nlm.nih.gov/30067315" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30067315</span></a>] [<a href="http://dx.crossref.org/10.1002/jrsm.1316" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>19.</dt><dd><div class="bk_ref" id="niceng237er2.ref19">Hubbard
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W, Walsh
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N, Hudson
|
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T, Heath
|
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A, Dietz
|
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J, Rogers
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G. Development and validation of paired MEDLINE and Embase search filters for cost-utility studies. <em>BMC Med Res Methodol</em>
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2022;<strong>22</strong>(1):310. 10.1186/s12874-022-01796-2
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[<a href="/pmc/articles/PMC9719242/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9719242</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/36463100" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36463100</span></a>] [<a href="http://dx.crossref.org/10.1186/s12874-022-01796-2" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>20.</dt><dd><div class="bk_ref" id="niceng237er2.ref20">van der Pol
|
|
S, Garcia
|
|
PR, Postma
|
|
MJ, Villar
|
|
FA, van Asselt
|
|
ADI. Economic Analyses of Respiratory Tract Infection Diagnostics: A Systematic Review. <em>Pharmacoeconomics</em>
|
|
2021;<strong>39</strong>(12):1411–27. 10.1007/s40273-021-01054-1
|
|
[<a href="/pmc/articles/PMC8279883/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8279883</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/34263422" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34263422</span></a>] [<a href="http://dx.crossref.org/10.1007/s40273-021-01054-1" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>21.</dt><dd><div class="bk_ref" id="niceng237er2.ref21">Ouzzani
|
|
M, Hammady
|
|
H, Fedorowicz
|
|
Z, Elmagarmid
|
|
A. Rayyan-a web and mobile app for systematic reviews. <em>Syst Rev</em>
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|
2016;<strong>5</strong>(1):210. 10.1186/s13643-016-0384-4
|
|
[<a href="/pmc/articles/PMC5139140/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5139140</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27919275" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27919275</span></a>] [<a href="http://dx.crossref.org/10.1186/s13643-016-0384-4" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>22.</dt><dd><div class="bk_ref" id="niceng237er2.ref22">Drummond
|
|
MF, Sculpher
|
|
MJ, Claxton
|
|
K, Stoddart
|
|
GL, Torrance
|
|
GW. <em>Methods for the economic evaluation of health care programmes</em>. 4 edn. Oxford, UK: Oxford University Press; 2015.</div></dd></dl><dl class="bkr_refwrap"><dt>23.</dt><dd><div class="bk_ref" id="niceng237er2.ref23">National Institute for Health and Care Excellence. Appendix H: Appraisal checklists, evidence tables, GRADE and economic profiles. <em>In:</em>
|
|
<em>Developing NICE guidelines: the manual Process and methods [PMG20]</em>. 2022. URL: <a href="https://www.nice.org.uk/process/pmg20/resources/appendix-h-appraisal-checklists-evidence-tables-grade-and-economic-profiles-pdf-8779777885" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.nice.org<wbr style="display:inline-block"></wbr>​.uk/process/pmg20/resources<wbr style="display:inline-block"></wbr>​/appendix-h-appraisal-checklists-evidence-tables-grade-and-economic-profiles-pdf-8779777885</a> (Accessed 31 May 2023).</div></dd></dl><dl class="bkr_refwrap"><dt>24.</dt><dd><div class="bk_ref" id="niceng237er2.ref24">Butler
|
|
CC, Gillespie
|
|
D, White
|
|
P, Bates
|
|
J, Lowe
|
|
R, Thomas-Jones
|
|
E, et al. C-Reactive Protein Testing to Guide Antibiotic Prescribing for COPD Exacerbations. <em>N Engl J Med</em>
|
|
2019;<strong>381</strong>(2):111–20. 10.1056/NEJMoa1803185
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/31291514" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31291514</span></a>] [<a href="http://dx.crossref.org/10.1056/NEJMoa1803185" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>25.</dt><dd><div class="bk_ref" id="niceng237er2.ref25">Little
|
|
P, Stuart
|
|
B, Francis
|
|
N, Douglas
|
|
E, Tonkin-Crine
|
|
S, Anthierens
|
|
S, et al. Effects of internet-based training on antibiotic prescribing rates for acute respiratory-tract infections: a multinational, cluster, randomised, factorial, controlled trial. <em>Lancet (london, england)</em>
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|
2013;<strong>382</strong>(9899):1175–82. 10.1016/S0140-6736(13)60994-0
|
|
[<a href="/pmc/articles/PMC3807804/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3807804</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/23915885" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23915885</span></a>] [<a href="http://dx.crossref.org/10.1016/S0140-6736(13)60994-0" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>26.</dt><dd><div class="bk_ref" id="niceng237er2.ref26">Cals
|
|
JW, Butler
|
|
CC, Hopstaken
|
|
RM, Hood
|
|
K, Dinant
|
|
GJ. Effect of point of care testing for C reactive protein and training in communication skills on antibiotic use in lower respiratory tract infections: cluster randomised trial. <em>BMJ (Clinical research ed)</em>
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2009;<strong>338</strong>:b1374. 10.1136/bmj.b1374 [<a href="/pmc/articles/PMC2677640/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2677640</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/19416992" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19416992</span></a>] [<a href="http://dx.crossref.org/10.1136/bmj.b1374" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>27.</dt><dd><div class="bk_ref" id="niceng237er2.ref27">Boere
|
|
TM, van Buul
|
|
LW, Hopstaken
|
|
RM, van Tulder
|
|
MW, Twisk
|
|
J, Verheij
|
|
TJM, et al. Effect of C reactive protein point-of-care testing on antibiotic prescribing for lower respiratory tract infections in nursing home residents: cluster randomised controlled trial. <em>BMJ</em>
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2021;<strong>374</strong>:n2198. 10.1136/bmj.n2198
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|
[<a href="/pmc/articles/PMC8453309/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8453309</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/34548288" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34548288</span></a>] [<a href="http://dx.crossref.org/10.1136/bmj.n2198" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>28.</dt><dd><div class="bk_ref" id="niceng237er2.ref28">Cals
|
|
JW, Schot
|
|
MJ, de Jong
|
|
SA, Dinant
|
|
GJ, Hopstaken
|
|
RM. Point-of-care C-reactive protein testing and antibiotic prescribing for respiratory tract infections: a randomized controlled trial. <em>Ann Fam Med</em>
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2010;<strong>8</strong>(2):124–33. 10.1370/afm.1090
|
|
[<a href="/pmc/articles/PMC2834719/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2834719</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/20212299" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20212299</span></a>] [<a href="http://dx.crossref.org/10.1370/afm.1090" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>29.</dt><dd><div class="bk_ref" id="niceng237er2.ref29">Andreeva
|
|
E, Melbye
|
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H. Usefulness of C-reactive protein testing in acute cough/respiratory tract infection: an open cluster-randomized clinical trial with C-reactive protein testing in the intervention group. <em>BMC Fam Pract</em>
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2014;<strong>15</strong>:80. 10.1186/1471-2296-15-80
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[<a href="/pmc/articles/PMC4016668/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4016668</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24886066" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24886066</span></a>] [<a href="http://dx.crossref.org/10.1186/1471-2296-15-80" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>30.</dt><dd><div class="bk_ref" id="niceng237er2.ref30">Althaus
|
|
T, Greer
|
|
RC, Swe
|
|
MMM, Cohen
|
|
J, Tun
|
|
NN, Heaton
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J, et al. Effect of point-of-care C-reactive protein testing on antibiotic prescription in febrile patients attending primary care in Thailand and Myanmar: an open-label, randomised, controlled trial. <em>Lancet Glob Health</em>
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2019;<strong>7</strong>(1):e119–e31. 10.1016/S2214-109X(18)30444-3
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[<a href="/pmc/articles/PMC6293968/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6293968</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30554748" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30554748</span></a>] [<a href="http://dx.crossref.org/10.1016/S2214-109X(18)30444-3" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>31.</dt><dd><div class="bk_ref" id="niceng237er2.ref31">Diederichsen
|
|
HZ, Skamling
|
|
M, Diederichsen
|
|
A, Grinsted
|
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P, Antonsen
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S, Petersen
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PH, et al. Randomised controlled trial of CRP rapid test as a guide to treatment of respiratory infections in general practice. <em>Scand J Prim Health Care</em>
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2000;<strong>18</strong>(1):39–43. 10.1080/02813430050202541
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[<a href="https://pubmed.ncbi.nlm.nih.gov/10811042" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10811042</span></a>] [<a href="http://dx.crossref.org/10.1080/02813430050202541" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>32.</dt><dd><div class="bk_ref" id="niceng237er2.ref32">Melbye
|
|
H, Aaraas
|
|
I, Fleten
|
|
N, Kolstrup
|
|
N, Mikalsen
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JI. The value of C-reactive protein testing in suspected lower respiratory tract infections. A study from general practice on the effect of a rapid test on antibiotic research and course of the disease in adults. <em>Tidsskr Nor Laegeforen</em>
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1995;<strong>115</strong>(13):1610–5.
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[<a href="https://pubmed.ncbi.nlm.nih.gov/7778075" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7778075</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>33.</dt><dd><div class="bk_ref" id="niceng237er2.ref33">Do
|
|
NT, Ta
|
|
NT, Tran
|
|
NT, Than
|
|
HM, Vu
|
|
BT, Hoang
|
|
LB, et al. Point-of-care C-reactive protein testing to reduce inappropriate use of antibiotics for non-severe acute respiratory infections in Vietnamese primary health care: a randomised controlled trial. <em>Lancet Glob Health</em>
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2016;<strong>4</strong>(9):e633–41. 10.1016/S2214-109X(16)30142-5
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[<a href="/pmc/articles/PMC4985565/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4985565</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27495137" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27495137</span></a>] [<a href="http://dx.crossref.org/10.1016/S2214-109X(16)30142-5" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>34.</dt><dd><div class="bk_ref" id="niceng237er2.ref34">Francis
|
|
NA, Gillespie
|
|
D, White
|
|
P, Bates
|
|
J, Lowe
|
|
R, Sewell
|
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B, et al. C-reactive protein point-of-care testing for safely reducing antibiotics for acute exacerbations of chronic obstructive pulmonary disease: the PACE RCT. <em>Health Technol Assess</em>
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2020;<strong>24</strong>(15):1–108. 10.3310/hta24150 [<a href="/pmc/articles/PMC7132534/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7132534</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32202490" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32202490</span></a>] [<a href="http://dx.crossref.org/10.3310/hta24150" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>35.</dt><dd><div class="bk_ref" id="niceng237er2.ref35">Cals
|
|
JW, de Bock
|
|
L, Beckers
|
|
PJ, Francis
|
|
NA, Hopstaken
|
|
RM, Hood
|
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K, et al. Enhanced communication skills and C-reactive protein point-of-care testing for respiratory tract infection: 3.5-year follow-up of a cluster randomized trial. <em>Ann Fam Med</em>
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2013;<strong>11</strong>(2):157–64. 10.1370/afm.1477
|
|
[<a href="/pmc/articles/PMC3601394/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3601394</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/23508603" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23508603</span></a>] [<a href="http://dx.crossref.org/10.1370/afm.1477" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>36.</dt><dd><div class="bk_ref" id="niceng237er2.ref36">Boere
|
|
TM, El Alili
|
|
M, van Buul
|
|
LW, Hopstaken
|
|
RM, Verheij
|
|
TJM, Hertogh
|
|
C, et al. Cost-effectiveness and return-on-investment of C-reactive protein point-of-care testing in comparison with usual care to reduce antibiotic prescribing for lower respiratory tract infections in nursing homes: a cluster randomised trial. <em>BMJ open</em>
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2022;<strong>12</strong>(9):e055234. 10.1136/bmjopen-2021-055234 [<a href="/pmc/articles/PMC9478864/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9478864</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/36109036" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36109036</span></a>] [<a href="http://dx.crossref.org/10.1136/bmjopen-2021-055234" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>37.</dt><dd><div class="bk_ref" id="niceng237er2.ref37">Little
|
|
P, Stuart
|
|
B, Francis
|
|
N, Douglas
|
|
E, Tonkin-Crine
|
|
S, Anthierens
|
|
S, et al. Antibiotic Prescribing for Acute Respiratory Tract Infections 12 Months After Communication and CRP Training: a Randomized Trial. <em>Ann Fam Med</em>
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|
2019;<strong>17</strong>(2):125–32. 10.1370/afm.2356
|
|
[<a href="/pmc/articles/PMC6411389/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6411389</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30858255" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30858255</span></a>] [<a href="http://dx.crossref.org/10.1370/afm.2356" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>38.</dt><dd><div class="bk_ref" id="niceng237er2.ref38">Lhopitallier
|
|
L, Kronenberg
|
|
A, Meuwly
|
|
JY, Locatelli
|
|
I, Mueller
|
|
Y, Senn
|
|
N, et al. Procalcitonin and lung ultrasonography point-of-care testing to determine antibiotic prescription in patients with lower respiratory tract infection in primary care: pragmatic cluster randomised trial. <em>BMJ</em>
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2021;<strong>374</strong>:n2132. 10.1136/bmj.n2132
|
|
[<a href="/pmc/articles/PMC9083102/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9083102</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/34548312" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34548312</span></a>] [<a href="http://dx.crossref.org/10.1136/bmj.n2132" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>39.</dt><dd><div class="bk_ref" id="niceng237er2.ref39">Llor
|
|
C, Madurell
|
|
J, Balagué-Corbella
|
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M, Gómez
|
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M, Cots
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JM. Impact on antibiotic prescription of rapid antigen detection testing in acute pharyngitis in adults: a randomised clinical trial. <em>Br J Gen Pract</em>
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2011;<strong>61</strong>(586):e244–51. 10.3399/bjgp11X572436
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[<a href="/pmc/articles/PMC3080229/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3080229</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/21619748" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21619748</span></a>] [<a href="http://dx.crossref.org/10.3399/bjgp11X572436" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>40.</dt><dd><div class="bk_ref" id="niceng237er2.ref40">Worrall
|
|
G, Hutchinson
|
|
J, Sherman
|
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G, Griffiths
|
|
J. Diagnosing streptococcal sore throat in adults: randomized controlled trial of in-office aids. <em>Can Fam Physician</em>
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2007;<strong>53</strong>(4):666–71.
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[<a href="/pmc/articles/PMC1952596/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1952596</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/17872717" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17872717</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>41.</dt><dd><div class="bk_ref" id="niceng237er2.ref41">Berthod
|
|
D, Genton
|
|
B, Hatz
|
|
C, Blum
|
|
J, de Vallière
|
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S. Ability of physicians to diagnose influenza and usefulness of a rapid influenza antigen test in febrile returning travelers: a randomized controlled trial. <em>Travel Med Infect Dis</em>
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2015;<strong>13</strong>(5):394–9. 10.1016/j.tmaid.2015.08.001
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[<a href="https://pubmed.ncbi.nlm.nih.gov/26358968" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26358968</span></a>] [<a href="http://dx.crossref.org/10.1016/j.tmaid.2015.08.001" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>42.</dt><dd><div class="bk_ref" id="niceng237er2.ref42"><em>Rapid Flu Tests in Travelers With Fever</em>. <a href="http://ClinicalTrials.gov" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">ClinicalTrials<wbr style="display:inline-block"></wbr>​.gov</a>; 2009. URL: <a href="https://www.clinicaltrials.gov/study/NCT00821626" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www.clinicaltrials.gov/study/NCT00821626</a> (Accessed 20 June 2023).</div></dd></dl><dl class="bkr_refwrap"><dt>43.</dt><dd><div class="bk_ref" id="niceng237er2.ref43">Benson
|
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MSG, R.; Kubilis, P. S.; Pierson, D. J.
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Erratum: Non-bronchoscopic diagnosis of Pneumocystis carinii pneumonia: Is it cost-effective? (Respiratory Care 1990; 35:1100). <em>Respir Care</em>
|
|
1991;<strong>36</strong>:22.</div></dd></dl><dl class="bkr_refwrap"><dt>44.</dt><dd><div class="bk_ref" id="niceng237er2.ref44">Wubishet
|
|
BL, Merlo
|
|
G, Ghahreman-Falconer
|
|
N, Hall
|
|
L, Comans
|
|
T. Economic evaluation of antimicrobial stewardship in primary care: a systematic review and quality assessment. <em>J Antimicrob Chemother</em>
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|
2022;<strong>77</strong>(9):2373–88. 10.1093/jac/dkac185
|
|
[<a href="/pmc/articles/PMC9410674/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9410674</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/35724206" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35724206</span></a>] [<a href="http://dx.crossref.org/10.1093/jac/dkac185" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>45.</dt><dd><div class="bk_ref" id="niceng237er2.ref45">Bilir
|
|
SP, Kruger
|
|
E, Faller
|
|
M, Munakata
|
|
J, Karichu
|
|
JK, Sickler
|
|
J, et al. US cost-effectiveness and budget impact of point-of-care NAAT for streptococcus. <em>Am J Manag Care</em>
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|
2021;<strong>27</strong>(5):e157–e63. 10.37765/ajmc.2021.88638
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/34002967" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34002967</span></a>] [<a href="http://dx.crossref.org/10.37765/ajmc.2021.88638" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>46.</dt><dd><div class="bk_ref" id="niceng237er2.ref46">Chew
|
|
R, Greer
|
|
RC, Tasak
|
|
N, Day
|
|
NPJ, Lubell
|
|
Y. Modelling the cost-effectiveness of pulse oximetry in primary care management of acute respiratory infection in rural northern Thailand. <em>Trop Med Int Health</em>
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|
2022;<strong>27</strong>(10):881–90. 10.1111/tmi.13812
|
|
[<a href="/pmc/articles/PMC9805201/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9805201</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/36054516" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36054516</span></a>] [<a href="http://dx.crossref.org/10.1111/tmi.13812" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>47.</dt><dd><div class="bk_ref" id="niceng237er2.ref47">Fraser
|
|
H, Gallacher
|
|
D, Achana
|
|
F, Court
|
|
R, Taylor-Phillips
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S, Nduka
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C, et al. Rapid antigen detection and molecular tests for group A streptococcal infections for acute sore throat: systematic reviews and economic evaluation. <em>Health Technol Assess</em>
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2020;<strong>24</strong>(31):1–232. 10.3310/hta24310 [<a href="/pmc/articles/PMC7355404/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7355404</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32605705" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32605705</span></a>] [<a href="http://dx.crossref.org/10.3310/hta24310" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>48.</dt><dd><div class="bk_ref" id="niceng237er2.ref48">Holmes
|
|
EAF, Harris
|
|
SD, Hughes
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A, Craine
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|
N, Hughes
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DA. Cost-Effectiveness Analysis of the Use of Point-of-Care C-Reactive Protein Testing to Reduce Antibiotic Prescribing in Primary Care. <em>Antibiotics</em>
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2018;<strong>7</strong>(4):07. 10.3390/antibiotics7040106 [<a href="/pmc/articles/PMC6315627/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6315627</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30544560" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30544560</span></a>] [<a href="http://dx.crossref.org/10.3390/antibiotics7040106" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>49.</dt><dd><div class="bk_ref" id="niceng237er2.ref49">Hunter
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R. Cost-effectiveness of point-of-care C-reactive protein tests for respiratory tract infection in primary care in England. <em>Adv Ther</em>
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2015;<strong>32</strong>(1):69–85. 10.1007/s12325-015-0180-x
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[<a href="/pmc/articles/PMC4311066/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4311066</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25620538" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25620538</span></a>] [<a href="http://dx.crossref.org/10.1007/s12325-015-0180-x" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>50.</dt><dd><div class="bk_ref" id="niceng237er2.ref50">Little
|
|
P, Hobbs
|
|
FD, Moore
|
|
M, Mant
|
|
D, Williamson
|
|
I, McNulty
|
|
C, et al. PRImary care Streptococcal Management (PRISM) study: in vitro study, diagnostic cohorts and a pragmatic adaptive randomised controlled trial with nested qualitative study and cost-effectiveness study. <em>Health Technol Assess</em>
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2014;<strong>18</strong>(6):vii–xxv, 1–101. 10.3310/hta18060 [<a href="/pmc/articles/PMC4781545/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4781545</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24467988" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24467988</span></a>] [<a href="http://dx.crossref.org/10.3310/hta18060" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>51.</dt><dd><div class="bk_ref" id="niceng237er2.ref51">Mac
|
|
S, O’Reilly
|
|
R, Adhikari
|
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NKJ, Fowler
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R, Sander
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B. Point-of-care diagnostic tests for influenza in the emergency department: A cost-effectiveness analysis in a high-risk population from a Canadian perspective. <em>PLoS One</em>
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2020;<strong>15</strong>(11):e0242255. 10.1371/journal.pone.0242255
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[<a href="/pmc/articles/PMC7668582/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7668582</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/33196653" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33196653</span></a>] [<a href="http://dx.crossref.org/10.1371/journal.pone.0242255" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>52.</dt><dd><div class="bk_ref" id="niceng237er2.ref52">Michaelidis
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|
CI, Zimmerman
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RK, Nowalk
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MP, Fine
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MJ, Smith
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KJ. Cost-effectiveness of procalcitonin-guided antibiotic therapy for outpatient management of acute respiratory tract infections in adults. <em>J Gen Intern Med</em>
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2014;<strong>29</strong>(4):579–86. 10.1007/s11606-013-2679-7
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[<a href="/pmc/articles/PMC3965735/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3965735</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24234394" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24234394</span></a>] [<a href="http://dx.crossref.org/10.1007/s11606-013-2679-7" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>53.</dt><dd><div class="bk_ref" id="niceng237er2.ref53">Neuner
|
|
JM, Hamel
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|
MB, Phillips
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RS, Bona
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|
K, Aronson
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|
MD. Diagnosis and management of adults with pharyngitis. A cost-effectiveness analysis. <em>Ann Intern Med</em>
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2003;<strong>139</strong>(2):113–22. 10.7326/0003-4819-139-2-200307150-00011
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[<a href="https://pubmed.ncbi.nlm.nih.gov/12859161" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12859161</span></a>] [<a href="http://dx.crossref.org/10.7326/0003-4819-139-2-200307150-00011" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>54.</dt><dd><div class="bk_ref" id="niceng237er2.ref54">Nicholson
|
|
KG, Abrams
|
|
KR, Batham
|
|
S, Medina
|
|
MJ, Warren
|
|
FC, Barer
|
|
M, et al. Randomised controlled trial and health economic evaluation of the impact of diagnostic testing for influenza, respiratory syncytial virus and Streptococcus pneumoniae infection on the management of acute admissions in the elderly and high-risk 18- to 64-year-olds. <em>Health Technol Assess</em>
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|
2014;<strong>18</strong>(36):1–274, vii–viii. 10.3310/hta18360 [<a href="/pmc/articles/PMC4781605/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4781605</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24875092" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24875092</span></a>] [<a href="http://dx.crossref.org/10.3310/hta18360" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>55.</dt><dd><div class="bk_ref" id="niceng237er2.ref55">Oppong
|
|
R, Jit
|
|
M, Smith
|
|
RD, Butler
|
|
CC, Melbye
|
|
H, Molstad
|
|
S, et al. Cost-effectiveness of point-of-care C-reactive protein testing to inform antibiotic prescribing decisions. <em>Br J Gen Pract</em>
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|
2013;<strong>63</strong>(612):e465–71. 10.3399/bjgp13X669185
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|
[<a href="/pmc/articles/PMC3693803/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3693803</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/23834883" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23834883</span></a>] [<a href="http://dx.crossref.org/10.3399/bjgp13X669185" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>56.</dt><dd><div class="bk_ref" id="niceng237er2.ref56">Rothberg
|
|
MB, Bellantonio
|
|
S, Rose
|
|
DN. Management of influenza in adults older than 65 years of age: cost-effectiveness of rapid testing and antiviral therapy. <em>Ann Intern Med</em>
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|
2003;<strong>139</strong>(5):321–9. 10.7326/0003-4819-139-5_part_1-200309020-00007
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/12965940" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12965940</span></a>] [<a href="http://dx.crossref.org/10.7326/0003-4819-139-5_part_1-200309020-00007" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>57.</dt><dd><div class="bk_ref" id="niceng237er2.ref57">Rothberg
|
|
MB, He
|
|
S, Rose
|
|
DN. Management of influenza symptoms in healthy adults. <em>J Gen Intern Med</em>
|
|
2003;<strong>18</strong>(10):808–15. 10.1046/j.1525-1497.2003.20822.x.
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|
[<a href="/pmc/articles/PMC1494927/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1494927</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/14521643" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 14521643</span></a>] [<a href="http://dx.crossref.org/10.1046/j.1525-1497.2003.20822.x" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>58.</dt><dd><div class="bk_ref" id="niceng237er2.ref58">Smith
|
|
KJ, Roberts
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|
MS. Cost-effectiveness of newer treatment strategies for influenza. <em>Am J Med</em>
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|
2002;<strong>113</strong>(4):300–7. 10.1016/s0002-9343(02)01222-6.
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|
[<a href="https://pubmed.ncbi.nlm.nih.gov/12361816" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12361816</span></a>] [<a href="http://dx.crossref.org/10.1016/s0002-9343(02)01222-6" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>59.</dt><dd><div class="bk_ref" id="niceng237er2.ref59">You
|
|
JHS, Tam
|
|
LP, Lee
|
|
NLS. Cost-effectiveness of molecular point-of-care testing for influenza viruses in elderly patients at ambulatory care setting. <em>PLoS ONE [Electronic Resource]</em>
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|
2017;<strong>12</strong>(7):e0182091. 10.1371/journal.pone.0182091
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|
[<a href="/pmc/articles/PMC5531460/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5531460</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28750092" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28750092</span></a>] [<a href="http://dx.crossref.org/10.1371/journal.pone.0182091" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>60.</dt><dd><div class="bk_ref" id="niceng237er2.ref60">Husereau
|
|
D, Drummond
|
|
M, Petrou
|
|
S, Carswell
|
|
C, Moher
|
|
D, Greenberg
|
|
D, et al. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. <em>Pharmacoeconomics</em>
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|
2013;<strong>31</strong>(5):361–7. 10.1007/s40273-013-0032-y
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/23529207" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23529207</span></a>] [<a href="http://dx.crossref.org/10.1007/s40273-013-0032-y" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</div></dd></dl><dl class="bkr_refwrap"><dt>61.</dt><dd><div class="bk_ref" id="niceng237er2.ref61">National Institute for Health and Care Excellence. <em>Pneumonia in adults: diagnosis and management: Clinical guideline [CG191]</em>. 2014. URL: <a href="https://www.nice.org.uk/guidance/cg191" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.nice.org.uk/guidance/cg191</a> (Accessed 14 June 2023). [<a href="https://pubmed.ncbi.nlm.nih.gov/31841289" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31841289</span></a>]</div></dd></dl></dl></div><div id="appendixesappgroup1"><h2 id="_appendixesappgroup1_">6. Appendices</h2><div id="niceng237er2.app1"><h3>Appendix 1. Review protocol</h3><p id="niceng237er2.app1.et1"><a href="/books/NBK598986/bin/niceng237er2-app1-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Version/Date: Version 1, 18 May 2023</a><span class="small"> (PDF, 376K)</span></p></div><div id="niceng237er2.app2"><h3>Appendix 2. Literature Search Strategies</h3><div id="niceng237er2.app2.s1"><h4>Searches for systematic reviews</h4><div id="niceng237er2.app2.s1.1"><h5>MEDLINE (Ovid)</h5><p>Searched: 04 May 2023</p><p>Ovid MEDLINE(R) ALL <1946 to May 03, 2023></p><ol><li class="half_rhythm"><div>Respiratory Tract Infections/ 42594</div></li><li class="half_rhythm"><div>exp Bronchitis/ or Common Cold/ or Infectious Mononucleosis/ or Influenza, Human/ or Laryngitis/ or exp Pharyngitis/ or exp Pneumonia/ or Severe Acute Respiratory Syndrome/ 433538</div></li><li class="half_rhythm"><div>((airway* or bronchopulmonar* or broncho-pulmonar* or tracheobronch* or tracheo-bronch* or pulmonar* tract or pulmonary or respirat* tract or respiratory) adj3 (infect* or coinfect* or inflamm*)).tw,kf. 122465</div></li><li class="half_rhythm"><div>((chest or lung? or lobar or pleura?) adj3 (absces* or infect* or coinfect* or inflamm*)).tw,kf. 44681</div></li><li class="half_rhythm"><div>(bronchit* or bronchopneumon* or common cold* or glandular fever or infectious mononucleosis or flu or influenza or laryngit* or laryngotracheobronchit* or laryngo tracheo bronchit* or laryngo tracheobronchit* or laryngotracheit* or nasopharyngit* or parainfluenza or pharyngit* or pneumoni* or pleuropneumoni* or rhinopharyngit* or severe acute respiratory syndrome or SARS or sore throat* or throat infection* or supraglottit* or supraglotit* or tonsillit* or tonsilit* or tracheit*).tw,kf. 520988</div></li><li class="half_rhythm"><div>((acute* or exacerbat* or flare*) adj3 (copd or coad or chronic obstructive pulmonary disease or chronic obstructive airway* disease or chronic obstructive lung disease)).mp. 10264</div></li><li class="half_rhythm"><div>((acute* or subacute* or exacerbat* or prolonged) adj3 cough*).mp. 1542</div></li><li class="half_rhythm"><div>(RTI or LRTI or URTI or ARTI or AURI or ALRI).tw,kf. 6290</div></li><li class="half_rhythm"><div>exp Respiratory System/ and (exp Viruses/ or exp Virus Diseases/) 34955</div></li><li class="half_rhythm"><div>exp pneumonia, viral/ or *orthomyxoviridae infections/ or influenza, human/ 288725</div></li><li class="half_rhythm"><div>((airway* or bronchopulmonar* or broncho-pulmonar* or tracheobronch* or tracheo-bronch* or pulmonar* tract or pulmonary or respirat* tract or respiratory) adj3 (nonbacter* or viral* or virus* or adenovir*)).tw,kf. 35760</div></li><li class="half_rhythm"><div>(rhinovir* or rhino* vir* or coryzavir* or coryza* vir* or influenzavir* or influenza* vir* or (H1N1 or H3N2) or parainfluenzavir* or parainfluenza* vir* or pneumovir* or pneumo* vir* or human metapneumovir* or human meta-pneumovir* or HMPV or respiratory syncytial vir*).mp. or RSV.tw,kf. 138771</div></li><li class="half_rhythm"><div>exp Respiratory System/ and (exp Bacteria/ or exp Bacterial Infections/) 48045</div></li><li class="half_rhythm"><div>pneumonia, bacterial/ or chlamydial pneumonia/ or pneumonia, mycoplasma/ or pneumonia, pneumococcal/ or pneumonia, staphylococcal/ 22808</div></li><li class="half_rhythm"><div>((airway* or bronchopulmonar* or broncho-pulmonar* or tracheobronch* or tracheo-bronch* or pulmonar* tract or pulmonary or respirat* tract or respiratory) adj3 (bacter* or bacilli* or bacili* or corynebac* or mycobac* or nonvir* or pathogen*)).tw,kf. 22594</div></li><li class="half_rhythm"><div>(strep* pneumon* or diplococ* pneumon* or pneumococ* or staph* pneumon* or chlamyd* pneumon* or myco* pneumon* or influenza bacil* or bacteri* influenza* or h?emophil* influenza*).mp. 80712</div></li><li class="half_rhythm"><div>((strep* adj3 (throat* or pharyn* or tonsil*)) or (strep* and (airway* or pulmonary or brochopulmonar* or brocho-pulmonar* or respiratory*))).mp. 22142</div></li><li class="half_rhythm"><div>(GABHS or (“group a” adj3 strep*)).tw,kf. 10718</div></li><li class="half_rhythm"><div>strep* pyogen*.mp. 18532</div></li><li class="half_rhythm"><div>1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9 or 10 or 11 or 12 or 13 or 14 or 15 or 16 or 17 or 18 or 19 [RTIs / RTI Viral Infection / RTI Bacterial Infection] 957868</div></li><li class="half_rhythm"><div>Point-of-Care Systems/ 16336</div></li><li class="half_rhythm"><div>(POCT or POCTs or (((point adj2 care) or poc) adj3 (analys* or antigen? or assay* or device? or immunoassay* or classif* or detect* or determin* or diagnos* or differenti* or identif* or method* or kit or kits or panel? or platform? or predict* or rapid or routine* or screen* or system* or technique* or test* or (cassette? or dipstick? or film* or stick or strip or fluorescent antibod*)))).tw,kf. 21606</div></li><li class="half_rhythm"><div>(point adj2 care).ti,kf. 14978</div></li><li class="half_rhythm"><div>(((near adj2 patient) or nearpatient or rapid* or bedside? or bed-side? or extra-laboratory or extralaboratory) adj3 (analys* or antigen? or assay* or immunoassay* or classif* or detect* or determin* or diagnos* or differenti* or identif* or method* or kit or kits or panel? or predict* or screen* or system* or technique* or test* or fluorescent antibod*)).tw,kf. 204252</div></li><li class="half_rhythm"><div>(((near adj2 patient) or nearpatient or bedside? or bed-side? or extra-laboratory or extralaboratory) adj3 rapid*).tw,kf. 635</div></li><li class="half_rhythm"><div>Rapid Diagnostic Tests/ 35</div></li><li class="half_rhythm"><div>(rapid* adj3 (detect* or diagnos* or screen*)).tw,kf. 71578</div></li><li class="half_rhythm"><div>(time-to-result? or ((quick* or rapid* or short* or time*) adj3 (turnaround or turn-around))).tw,kf. 8081</div></li><li class="half_rhythm"><div>(antigen? adj3 (analys* or assay* or immunoassay* or classif* or detect* or determin* or diagnos* or differenti* or identif* or method* or kit or kits or panel? or predict* or rapid or routine* or screen* or system* or technique* or test*)).tw,kf. 90702</div></li><li class="half_rhythm"><div>(RADT or RADTs or RDT or RDTs).tw,kf. 3308</div></li><li class="half_rhythm"><div>(rapid molecular or multiplex*).mp. 72823</div></li><li class="half_rhythm"><div>lab-on-a-chip.tw,kf. 3494</div></li><li class="half_rhythm"><div>((lateral flow adj (assay* or immunoassay* or test*)) or LFA or LFIA).tw,kf. 9954</div></li><li class="half_rhythm"><div>(immunochromatograph* or immuno-chromatograph* or immuno-chromato-graph* or direct immunofluorescence or direct immuno-fluorescence or enzym* immunoassay* or enzym* immuno-assay* or fluorescence immunoassay* or fluorescence immuno-assay* or optical immunoassay* or optical immuno-assay*).mp. or (ICA or EIA or FIA or OIA).tw,kf. 60364</div></li><li class="half_rhythm"><div>((chemiluminescen* or chemi-luminescen*) adj (immunoassay* or immuno-assay* or assay*)).mp. 4693</div></li><li class="half_rhythm"><div>(((mobile or portable or handheld or hand-held) adj3 (analy#er? or device? or meters or metres)) and (blood? or plasma or saliva or sputum or spit or mucus or urine or urea or urinalys* or fluids or gas or gases)).mp. 2602</div></li><li class="half_rhythm"><div>21 or 22 or 23 or 24 or 25 or 26 or 27 or 28 or 29 or 30 or 31 or 32 or 33 or 34 or 35 or 36 [Rapid Tests] 452888</div></li><li class="half_rhythm"><div>20 and 37 [RTIs / RTI Viral Infection / RTI Bacterial Infection AND Rapid Tests] 33006</div></li><li class="half_rhythm"><div>(systematic review or meta-analysis).pt. 309240</div></li><li class="half_rhythm"><div>meta-analysis/ or systematic review/ or systematic reviews as topic/ or meta-analysis as topic/ or “meta analysis (topic)”/ or “systematic review (topic)”/ or exp technology assessment, biomedical/ or network meta-analysis/ 347218</div></li><li class="half_rhythm"><div>((systematic* adj3 (review* or overview*)) or (methodologic* adj3 (review* or overview*))).ti,ab,kf. 313541</div></li><li class="half_rhythm"><div>((quantitative adj3 (review* or overview* or synthes*)) or (research adj3 (integrati* or overview*))).ti,ab,kf. 15381</div></li><li class="half_rhythm"><div>((integrative adj3 (review* or overview*)) or (collaborative adj3 (review* or overview*)) or (pool* adj3 analy*)).ti,ab,kf. 38276</div></li><li class="half_rhythm"><div>(data synthes* or data extraction* or data abstraction*).ti,ab,kf. 39706</div></li><li class="half_rhythm"><div>(handsearch* or hand search*).ti,ab,kf. 11062</div></li><li class="half_rhythm"><div>(mantel haenszel or peto or der simonian or dersimonian or fixed effect* or latin square*).ti,ab,kf. 35169</div></li><li class="half_rhythm"><div>(met analy* or metanaly* or technology assessment* or HTA or HTAs or technology overview* or technology appraisal*).ti,ab,kf. 11998</div></li><li class="half_rhythm"><div>(meta regression* or metaregression*).ti,ab,kf. 14264</div></li><li class="half_rhythm"><div>(meta-analy* or metaanaly* or systematic review* or biomedical technology assessment* or bio-medical technology assessment*).mp,hw. 459155</div></li><li class="half_rhythm"><div>(medline or cochrane or pubmed or medlars or embase or cinahl).ti,ab,hw. 335245</div></li><li class="half_rhythm"><div>(cochrane or (health adj2 technology assessment) or evidence report).jw. 21350</div></li><li class="half_rhythm"><div>(comparative adj3 (efficacy or effectiveness)).ti,ab,kf. 17353</div></li><li class="half_rhythm"><div>(outcomes research or relative effectiveness).ti,ab,kf. 11149</div></li><li class="half_rhythm"><div>((indirect or indirect treatment or mixed-treatment or bayesian) adj3 comparison*).ti,ab,kf. 4285</div></li><li class="half_rhythm"><div>(multi* adj3 treatment adj3 comparison*).ti,ab,kf. 291</div></li><li class="half_rhythm"><div>(mixed adj3 treatment adj3 (meta-analy* or metaanaly*)).ti,ab,kf. 178</div></li><li class="half_rhythm"><div>umbrella review*.ti,ab,kf. 1411</div></li><li class="half_rhythm"><div>(multi* adj2 paramet* adj2 evidence adj2 synthesis).ti,ab,kf. 14</div></li><li class="half_rhythm"><div>(multiparamet* adj2 evidence adj2 synthesis).ti,ab,kf. 18</div></li><li class="half_rhythm"><div>(multi-paramet* adj2 evidence adj2 synthesis).ti,ab,kf. 12</div></li><li class="half_rhythm"><div>or/39-60 [CADTH SR filter] 672225</div></li><li class="half_rhythm"><div>38 and 61 [RTIs / RTI Viral Infection / RTI Bacterial Infection AND Rapid Tests AND CADTH SR filter] 901</div></li><li class="half_rhythm"><div>(metaanalys* or meta analys* or NMA* or MAIC* or indirect comparison* or mixed treatment comparison*).mp. 303671</div></li><li class="half_rhythm"><div>(systematic* adj3 (review* or overview* or search or literature)).mp. 351213</div></li><li class="half_rhythm"><div>63 or 64 [in-house SR filter] 485892</div></li><li class="half_rhythm"><div>38 and 65 [RTIs / RTI Viral Infection / RTI Bacterial Infection AND Rapid Tests AND in-house SR filter] 642</div></li><li class="half_rhythm"><div>62 or 66 [RTIs / RTI Viral Infection / RTI Bacterial Infection AND Rapid Tests AND either SR filter] 906</div></li><li class="half_rhythm"><div>limit 67 to english language 875</div></li><li class="half_rhythm"><div>limit 68 to (comment or editorial or letter or news) 19</div></li><li class="half_rhythm"><div>68 not 69 856</div></li></ol><p>Total after 7 duplicates identified in EndNote removed: 849</p></div><div id="niceng237er2.app2.s1.2"><h5>Epistemonikos</h5><p>Searched: 11 May 2023</p><p>title:((((airway* OR bronchopulmonar* OR broncho-pulmonar* OR tracheobronch* OR tracheo-bronch* OR pulmonary OR respiratory OR chest OR lung* OR lobar OR pleura*) AND (infect* OR coinfect* OR inflamm* OR nonbacter* OR viral* OR virus* OR adenovir* OR bacter* OR bacilli* OR bacili* OR corynebac* OR mycobac* OR nonvir* OR pathogen*)) OR (bronchit* OR bronchopneumon* OR “common cold” OR “glandular fever” OR “infectious mononucleosis” OR flu OR influenza OR laryngit* OR laryngotracheobronchit* OR “laryngo tracheo bronchitis” OR “laryngo tracheobronchitis” OR laryngotracheit* OR nasopharyngit* OR parainfluenza OR pharyngit* OR pneumoni* OR pleuropneumoni* OR rhinopharyngit* OR “severe acute respiratory syndrome” OR SARS OR “sore throat” OR “throat infection” OR supraglottit* OR supraglotit* OR tonsillit* OR tonsilit* OR tracheit*) OR ((acute* OR exacerbat* OR flare*) AND (copd OR coad OR “chronic obstructive pulmonary disease” OR “chronic obstructive airway disease” OR “chronic obstructive lung disease”)) OR (“acute cough” OR “subacute cough” OR “exacerbated cough” OR “prolonged cough” OR “acute coughing” OR “subacute coughing” OR “exacerbated coughing” OR “prolonged coughing”) OR (RTI OR LRTI OR URTI OR ARTI OR AURI OR ALRI) OR (rhinovir* OR “rhino virus” OR coryzavir* OR “coryza virus” OR influenzavir* OR “influenza virus” OR H1N1 OR H3N2 OR parainfluenzavir* OR “parainfluenza virus” OR pneumovir* OR “pneumo virus” OR “human metapneumovirus” OR “human meta-pneumovirus” OR HMPV OR “respiratory syncytial virus” OR RSV) OR (((strep* OR diplococ* OR pneumococ* OR staph* OR chlamyd* OR myco*) AND pneumon*) OR ((bacil* OR bacteri* OR haemophil* OR hemophil*) AND influenza*)) OR ((strep* AND (throat* OR pharyn* OR tonsil* OR airway* OR pulmonary OR brochopulmonar* OR brocho-pulmonar* OR respiratory* OR pyogen*))) OR (GABHS OR (“group a” AND strep*)))) AND (title:((POCT OR POCTs OR ((“point of care” OR “near patient” OR near-patient OR nearpatient OR bedside* OR bed-side* OR extra-laboratory OR extralaboratory OR time-to-result* OR quick* OR rapid* OR short* OR antigen*) AND (analys* OR assay* OR immunoassay* OR classif* OR detect* OR determin* OR diagnos* OR differenti* OR identif* OR method* OR kit OR kits OR panel* OR predict* OR routine* OR screen* OR system* OR technique* OR test*)) OR (RADT OR RADTs OR RDT OR RDTs OR “rapid molecular” OR multiplex* OR “lab-on-a-chip”) OR (((mobile OR portable OR handheld OR hand-held) AND (analyser* OR analyzer* OR device* OR meters OR metres)) AND (blood* OR plasma OR saliva OR sputum OR spit OR mucus OR urine OR urea OR urinalys* OR fluids OR gas OR gases)))) OR abstract:((POCT OR POCTs OR ((“point of care” OR “near patient” OR near-patient OR nearpatient OR bedside* OR bed-side* OR extra-laboratory OR extralaboratory OR time-to-result* OR quick* OR rapid* OR short* OR antigen*) AND (analys* OR assay* OR immunoassay* OR classif* OR detect* OR determin* OR diagnos* OR differenti* OR identif* OR method* OR kit OR kits OR panel* OR predict* OR routine* OR screen* OR system* OR technique* OR test*)) OR (RADT OR RADTs OR RDT OR RDTs OR “rapid molecular” OR multiplex* OR “lab-on-a-chip”) OR (((mobile OR portable OR handheld OR hand-held) AND (analyser* OR analyzer* OR device* OR meters OR metres)) AND (blood* OR plasma OR saliva OR sputum OR spit OR mucus OR urine OR urea OR urinalys* OR fluids OR gas OR gases)))))</p><p>Limited to:</p><p>Publication Type: Systematic Reviews</p><p>Total: 617</p></div></div><div id="niceng237er2.app2.s2"><h4>Searches for RCTs</h4><div id="niceng237er2.app2.s2.1"><h5>CENTRAL (Wiley)</h5><p>Search Name: Acute Respiratory Infections RCTs</p><p>Date Run: 26/05/2023 22:22:45</p><p>Comment: 26 May 2023</p><dl class="temp-labeled-list"><li class="half_rhythm"><p class="no_top_margin">ID Search Hits</p></li><dl class="bkr_refwrap"><dt>#1.</dt><dd><p class="no_top_margin">[mh ^“Respiratory Tract Infections”] 2777</p></dd></dl><dl class="bkr_refwrap"><dt>#2.</dt><dd><p class="no_top_margin">[mh Bronchitis] OR [mh ^“Common Cold”] OR [mh ^“Infectious Mononucleosis”] OR [mh ^“Influenza, Human”] OR [mh ^Laryngitis] OR [mh Pharyngitis] OR [mh Pneumonia] OR [mh ^“Severe Acute Respiratory Syndrome”] 17706</p></dd></dl><dl class="bkr_refwrap"><dt>#3.</dt><dd><p class="no_top_margin">((airway* OR bronchopulmonar* OR broncho-pulmonar* OR tracheobronch* OR tracheo-bronch* OR (pulmonar* NEXT tract) OR pulmonary OR (respirat* NEXT tract) OR respiratory) NEAR/3 (infect* OR coinfect* OR inflamm*)):ti,ab,kw 18614</p></dd></dl><dl class="bkr_refwrap"><dt>#4.</dt><dd><p class="no_top_margin">((chest OR lung? OR lobar OR pleura?) NEAR/3 (absces* OR infect* OR coinfect* OR inflamm*)):ti,ab,kw 4150</p></dd></dl><dl class="bkr_refwrap"><dt>#5.</dt><dd><p class="no_top_margin">(bronchit* OR bronchopneumon* OR (common NEXT cold*) OR “glandular fever” OR “infectious mononucleosis” OR flu OR influenza OR laryngit* OR laryngotracheobronchit* OR (“laryngo tracheo” NEXT bronchit*) OR (laryngo NEXT tracheobronchit*) OR laryngotracheit* OR nasopharyngit* OR parainfluenza OR pharyngit* OR pneumoni* OR pleuropneumoni* OR rhinopharyngit* OR “severe acute respiratory syndrome” OR SARS OR (sore NEXT throat*) OR (throat NEXT infection*) OR supraglottit* OR supraglotit* OR tonsillit* OR tonsilit* OR tracheit*):ti,ab,kw 51341</p></dd></dl><dl class="bkr_refwrap"><dt>#6.</dt><dd><p class="no_top_margin">((acute* OR exacerbat* OR flare*) NEAR/3 (copd OR coad OR “chronic obstructive pulmonary disease” OR (“chronic obstructive” NEXT airway* NEXT disease) OR “chronic obstructive lung disease”)):ti,ab,kw 4040</p></dd></dl><dl class="bkr_refwrap"><dt>#7.</dt><dd><p class="no_top_margin">((acute* OR subacute* OR exacerbat* OR prolonged) NEAR/3 cough*):ti,ab,kw 525</p></dd></dl><dl class="bkr_refwrap"><dt>#8.</dt><dd><p class="no_top_margin">(RTI OR LRTI OR URTI OR ARTI OR AURI OR ALRI):ti,ab,kw 1399</p></dd></dl><dl class="bkr_refwrap"><dt>#9.</dt><dd><p class="no_top_margin">[mh “Respiratory System”] AND ([mh Viruses] OR [mh “Virus Diseases”]) 453</p></dd></dl><dl class="bkr_refwrap"><dt>#10.</dt><dd><p class="no_top_margin">[mh “pneumonia, viral”] OR [mh ^“orthomyxoviridae infections”] OR [mh ^“influenza, human”] 7578</p></dd></dl><dl class="bkr_refwrap"><dt>#11.</dt><dd><p class="no_top_margin">((airway* OR bronchopulmonar* OR broncho-pulmonar* OR tracheobronch* OR tracheo-bronch* OR (pulmonar* NEXT tract) OR pulmonary OR (respirat* NEXT tract) OR respiratory) NEAR/3 (nonbacter* OR viral* OR virus* OR adenovir*)):ti,ab,kw 2500</p></dd></dl><dl class="bkr_refwrap"><dt>#12.</dt><dd><p class="no_top_margin">(rhinovir* OR (rhino* NEXT vir*) OR coryzavir* OR (coryza* NEXT vir*) OR influenzavir* OR (influenza* NEXT vir*) OR (H1N1 OR H3N2) OR parainfluenzavir* OR (parainfluenza* NEXT vir*) OR pneumovir* OR (pneumo* NEXT vir*) OR (human NEXT metapneumovir*) OR (human NEXT meta-pneumovir*) OR HMPV OR (“respiratory syncytial” NEXT vir*) OR RSV):ti,ab,kw 4910</p></dd></dl><dl class="bkr_refwrap"><dt>#13.</dt><dd><p class="no_top_margin">[mh “Respiratory System”] AND ([mh Bacteria] OR [mh “Bacterial Infections”]) 874</p></dd></dl><dl class="bkr_refwrap"><dt>#14.</dt><dd><p class="no_top_margin">[mh ^“pneumonia, bacterial”] OR [mh ^“chlamydial pneumonia”] OR [mh ^“pneumonia, mycoplasma”] OR [mh ^“pneumonia, pneumococcal”] OR [mh ^“pneumonia, staphylococcal”] 946</p></dd></dl><dl class="bkr_refwrap"><dt>#15.</dt><dd><p class="no_top_margin">((airway* OR bronchopulmonar* OR broncho-pulmonar* OR tracheobronch* OR tracheo-bronch* OR (pulmonar* NEXT tract) OR pulmonary OR (respirat* NEXT tract) OR respiratory) NEAR/3 (bacter* OR bacilli* OR bacili* OR corynebac* OR mycobac* OR nonvir* OR pathogen*)):ti,ab,kw 1072</p></dd></dl><dl class="bkr_refwrap"><dt>#16.</dt><dd><p class="no_top_margin">((strep* NEXT pneumon*) OR (diplococ* NEXT pneumon*) OR pneumococ* OR (staph* NEXT pneumon*) OR (chlamyd* NEXT pneumon*) OR (myco* NEXT pneumon*) OR (influenza NEXT bacil*) OR (bacteri* NEXT influenza*) OR (hemophil* NEXT influenza*) OR (haemophil* NEXT influenza*)):ti,ab,kw 5166</p></dd></dl><dl class="bkr_refwrap"><dt>#17.</dt><dd><p class="no_top_margin">((strep* NEAR/3 (throat* OR pharyn* OR tonsil*)) OR (strep* AND (airway* OR pulmonary OR brochopulmonar* OR brocho-pulmonar* OR respiratory*))):ti,ab,kw 1729</p></dd></dl><dl class="bkr_refwrap"><dt>#18.</dt><dd><p class="no_top_margin">(GABHS OR (“group a” NEAR/3 strep*)):ti,ab,kw 496</p></dd></dl><dl class="bkr_refwrap"><dt>#19.</dt><dd><p class="no_top_margin">(strep* NEXT pyogen*):ti,ab,kw 494</p></dd></dl><dl class="bkr_refwrap"><dt>#20.</dt><dd><p class="no_top_margin">#1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7 OR #8 OR #9 OR #10 OR #11 OR #12 OR #13 OR #14 OR #15 OR #16 OR #17 OR #18 OR #19 74475</p></dd></dl><dl class="bkr_refwrap"><dt>#21.</dt><dd><p class="no_top_margin">[mh ^“Point-of-Care Systems”] 575</p></dd></dl><dl class="bkr_refwrap"><dt>#22.</dt><dd><p class="no_top_margin">(POCT OR POCTs OR (((point NEAR/2 care) OR poc) NEAR/3 (analys* OR antigen? OR assay* OR device? OR immunoassay* OR classif* OR detect* OR determin* OR diagnos* OR differenti* OR identif* OR method* OR kit OR kits OR panel? OR platform? OR predict* OR rapid OR routine* OR screen* OR system* OR technique* OR test* OR cassette? OR dipstick? OR film* OR stick OR strip OR (fluorescent NEXT antibod*)))):ti,ab,kw 2015</p></dd></dl><dl class="bkr_refwrap"><dt>#23.</dt><dd><p class="no_top_margin">(point NEAR/2 care):ti,kw 1372</p></dd></dl><dl class="bkr_refwrap"><dt>#24.</dt><dd><p class="no_top_margin">((“near patient” OR “near-patient” OR nearpatient OR rapid* OR bedside? OR bed-side? OR extra-laboratory OR extralaboratory) NEAR/3 (analys* OR antigen? OR assay* OR immunoassay* OR classif* OR detect* OR determin* OR diagnos* OR differenti* OR identif* OR method* OR kit OR kits OR panel? OR predict* OR screen* OR system* OR technique* OR test* OR (fluorescent NEXT antibod*))):ti,ab,kw 6530</p></dd></dl><dl class="bkr_refwrap"><dt>#25.</dt><dd><p class="no_top_margin">((“near patient” OR “near-patient” OR nearpatient OR bedside? OR bed-side? OR extra-laboratory OR extralaboratory) NEAR/3 rapid*):ti,ab,kw 39</p></dd></dl><dl class="bkr_refwrap"><dt>#26.</dt><dd><p class="no_top_margin">[mh ^“Rapid Diagnostic Tests”] 0</p></dd></dl><dl class="bkr_refwrap"><dt>#27.</dt><dd><p class="no_top_margin">(rapid* NEAR/3 (detect* OR diagnos* OR screen*)):ti,ab,kw 1611</p></dd></dl><dl class="bkr_refwrap"><dt>#28.</dt><dd><p class="no_top_margin">(time-to-result? OR ((quick* OR rapid* OR short* OR time*) NEAR/3 (turnaround OR turn-around))):ti,ab,kw 314</p></dd></dl><dl class="bkr_refwrap"><dt>#29.</dt><dd><p class="no_top_margin">(antigen? NEAR/3 (analys* OR assay* OR immunoassay* OR classif* OR detect* OR determin* OR diagnos* OR differenti* OR identif* OR method* OR kit OR kits OR panel? OR predict* OR rapid OR routine* OR screen* OR system* OR technique* OR test*)):ti,ab,kw 4499</p></dd></dl><dl class="bkr_refwrap"><dt>#30.</dt><dd><p class="no_top_margin">(RADT OR RADTs OR RDT OR RDTs):ti,ab,kw 485</p></dd></dl><dl class="bkr_refwrap"><dt>#31.</dt><dd><p class="no_top_margin">(“rapid molecular” OR multiplex*):ti,ab,kw 1767</p></dd></dl><dl class="bkr_refwrap"><dt>#32.</dt><dd><p class="no_top_margin">lab-on-a-chip:ti,ab,kw 0</p></dd></dl><dl class="bkr_refwrap"><dt>#33.</dt><dd><p class="no_top_margin">((“lateral flow” NEXT (assay* OR immunoassay* OR test*)) OR LFA OR LFIA):ti,ab,kw 206</p></dd></dl><dl class="bkr_refwrap"><dt>#34.</dt><dd><p class="no_top_margin">(immunochromatograph* OR immuno-chromatograph* OR immuno-chromato-graph* OR “direct immunofluorescence” OR “direct immuno-fluorescence” OR (enzym* NEXT immunoassay*) OR (enzym* NEXT immuno-assay*) OR (“fluorescence” NEXT immunoassay*) OR (“fluorescence” NEXT immuno-assay*) OR (“optical” NEXT immunoassay*) OR (“optical” NEXT immuno-assay*)) OR (ICA OR EIA OR FIA OR OIA):ti,ab,kw 2911</p></dd></dl><dl class="bkr_refwrap"><dt>#35.</dt><dd><p class="no_top_margin">((chemiluminescen* OR chemi-luminescen*) NEXT (immunoassay* OR immuno-assay* OR assay*)):ti,ab,kw 500</p></dd></dl><dl class="bkr_refwrap"><dt>#36.</dt><dd><p class="no_top_margin">(((mobile OR portable OR handheld OR hand-held) NEAR/3 (analyser? OR analyzer? OR device? OR meters OR metres)) AND (blood? OR plasma OR saliva OR sputum OR spit OR mucus OR urine OR urea OR urinalys* OR fluids OR gas OR gases)):ti,ab,kw 546</p></dd></dl><dl class="bkr_refwrap"><dt>#37.</dt><dd><p class="no_top_margin">((biomarker* OR procalcitonin* OR PCT OR “c reactive protein” OR “c-reactive protein” OR “C-reactive protein” OR CRP OR leucocyte OR leukocyte OR neutrophil* OR (“white blood cell” NEXT count*) OR wbc OR wbcc OR sodium OR “partial pressure of oxygen” OR “partial pressure O2” OR PaO2 OR “blood count” OR “platelet count” OR CBC OR FBC OR (“blood” NEXT exam*) OR (blood NEXT test*) OR (blood NEXT draw*) OR haematolog* OR hematolog* OR haemoglobin OR hemoglobin OR haematocrit OR hematocrit OR “white blood cell” OR “red blood cell” OR “mean platelet volume” OR “mean corpuscular volume” OR “mean corpuscular haemoglobin” OR “mean corpuscular hemoglobin” OR platelet* OR basophil* OR eosinophil* OR lymphocyte* OR monocyte* OR erythrocyte*) NEAR/3 (guid* OR direct* OR steer* OR inform* OR algorithm-guided OR algorithm-directed OR algorithm-steered OR algorithm-informed)):ti,ab,kw 1968</p></dd></dl><dl class="bkr_refwrap"><dt>#38.</dt><dd><p class="no_top_margin">#21 OR #22 OR #23 OR #24 OR #25 OR #26 OR #27 OR #28 OR #29 OR #30 OR #31 OR #32 OR #33 OR #34 OR #35 OR #36 OR #37 20117</p></dd></dl><dl class="bkr_refwrap"><dt>#39.</dt><dd><p class="no_top_margin">#20 AND #38 2081</p></dd></dl></dl><ul class="simple-list"><li class="half_rhythm"><div>CDSR: 37</div></li><li class="half_rhythm"><div>Protocols: 3</div></li><li class="half_rhythm"><div>CENTRAL: 2035</div></li><li class="half_rhythm"><div>Editorials: 1</div></li><li class="half_rhythm"><div>Clinical Answers: 5</div></li></ul></div><div id="niceng237er2.app2.s2.2"><h5>MEDLINE (Ovid)</h5><p>Searched: 26 May 2023</p><p>Ovid MEDLINE(R) ALL <1946 to May 25, 2023></p><ol><li class="half_rhythm"><div>Respiratory Tract Infections/ 42643</div></li><li class="half_rhythm"><div>exp Bronchitis/ or Common Cold/ or Infectious Mononucleosis/ or Influenza, Human/ or Laryngitis/ or exp Pharyngitis/ or exp Pneumonia/ or Severe Acute Respiratory Syndrome/ 436904</div></li><li class="half_rhythm"><div>((airway* or bronchopulmonar* or broncho-pulmonar* or tracheobronch* or tracheo-bronch* or pulmonar* tract or pulmonary or respirat* tract or respiratory) adj3 (infect* or coinfect* or inflamm*)).tw,kf. 122877</div></li><li class="half_rhythm"><div>((chest or lung? or lobar or pleura?) adj3 (absces* or infect* or coinfect* or inflamm*)).tw,kf. 44844</div></li><li class="half_rhythm"><div>(bronchit* or bronchopneumon* or common cold* or glandular fever or infectious mononucleosis or flu or influenza or laryngit* or laryngotracheobronchit* or laryngo tracheo bronchit* or laryngo tracheobronchit* or laryngotracheit* or nasopharyngit* or parainfluenza or pharyngit* or pneumoni* or pleuropneumoni* or rhinopharyngit* or severe acute respiratory syndrome or SARS or sore throat* or throat infection* or supraglottit* or supraglotit* or tonsillit* or tonsilit* or tracheit*).tw,kf. 523527</div></li><li class="half_rhythm"><div>((acute* or exacerbat* or flare*) adj3 (copd or coad or chronic obstructive pulmonary disease or chronic obstructive airway* disease or chronic obstructive lung disease)).mp. 10315</div></li><li class="half_rhythm"><div>((acute* or subacute* or exacerbat* or prolonged) adj3 cough*).mp. 1549</div></li><li class="half_rhythm"><div>(RTI or LRTI or URTI or ARTI or AURI or ALRI).tw,kf. 6320</div></li><li class="half_rhythm"><div>exp Respiratory System/ and (exp Viruses/ or exp Virus Diseases/) 35017</div></li><li class="half_rhythm"><div>exp pneumonia, viral/ or *orthomyxoviridae infections/ or influenza, human/ 291951</div></li><li class="half_rhythm"><div>((airway* or bronchopulmonar* or broncho-pulmonar* or tracheobronch* or tracheo-bronch* or pulmonar* tract or pulmonary or respirat* tract or respiratory) adj3 (nonbacter* or viral* or virus* or adenovir*)).tw,kf. 35921</div></li><li class="half_rhythm"><div>(rhinovir* or rhino* vir* or coryzavir* or coryza* vir* or influenzavir* or influenza* vir* or (H1N1 or H3N2) or parainfluenzavir* or parainfluenza* vir* or pneumovir* or pneumo* vir* or human metapneumovir* or human meta-pneumovir* or HMPV or respiratory syncytial vir*).mp. or RSV.tw,kf. 139001</div></li><li class="half_rhythm"><div>exp Respiratory System/ and (exp Bacteria/ or exp Bacterial Infections/) 48085</div></li><li class="half_rhythm"><div>pneumonia, bacterial/ or chlamydial pneumonia/ or pneumonia, mycoplasma/ or pneumonia, pneumococcal/ or pneumonia, staphylococcal/ 22815</div></li><li class="half_rhythm"><div>((airway* or bronchopulmonar* or broncho-pulmonar* or tracheobronch* or tracheo-bronch* or pulmonar* tract or pulmonary or respirat* tract or respiratory) adj3 (bacter* or bacilli* or bacili* or corynebac* or mycobac* or nonvir* or pathogen*)).tw,kf. 22660</div></li><li class="half_rhythm"><div>(strep* pneumon* or diplococ* pneumon* or pneumococ* or staph* pneumon* or chlamyd* pneumon* or myco* pneumon* or influenza bacil* or bacteri* influenza* or h?emophil* influenza*).mp. 80816</div></li><li class="half_rhythm"><div>((strep* adj3 (throat* or pharyn* or tonsil*)) or (strep* and (airway* or pulmonary or brochopulmonar* or brocho-pulmonar* or respiratory*))).mp. 22180</div></li><li class="half_rhythm"><div>(GABHS or (“group a” adj3 strep*)).tw,kf. 10737</div></li><li class="half_rhythm"><div>strep* pyogen*.mp. 18547</div></li><li class="half_rhythm"><div>1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9 or 10 or 11 or 12 or 13 or 14 or 15 or 16 or 17 or 18 or 19 [RTIs / RTI Viral Infection / RTI Bacterial Infection] 962908</div></li><li class="half_rhythm"><div>Point-of-Care Systems/ 16388</div></li><li class="half_rhythm"><div>(POCT or POCTs or (((point adj2 care) or poc) adj3 (analys* or antigen? or assay* or device? or immunoassay* or classif* or detect* or determin* or diagnos* or differenti* or identif* or method* or kit or kits or panel? or platform? or predict* or rapid or routine* or screen* or system* or technique* or test* or (cassette? or dipstick? or film* or stick or strip or fluorescent antibod*)))).tw,kf. 21789</div></li><li class="half_rhythm"><div>(point adj2 care).ti,kf. 15117</div></li><li class="half_rhythm"><div>(((near adj2 patient) or nearpatient or rapid* or bedside? or bed-side? or extra-laboratory or extralaboratory) adj3 (analys* or antigen? or assay* or immunoassay* or classif* or detect* or determin* or diagnos* or differenti* or identif* or method* or kit or kits or panel? or predict* or screen* or system* or technique* or test* or fluorescent antibod*)).tw,kf. 204945</div></li><li class="half_rhythm"><div>(((near adj2 patient) or nearpatient or bedside? or bed-side? or extra-laboratory or extralaboratory) adj3 rapid*).tw,kf. 639</div></li><li class="half_rhythm"><div>Rapid Diagnostic Tests/ 43</div></li><li class="half_rhythm"><div>(rapid* adj3 (detect* or diagnos* or screen*)).tw,kf. 71887</div></li><li class="half_rhythm"><div>(time-to-result? or ((quick* or rapid* or short* or time*) adj3 (turnaround or turn-around))).tw,kf. 8134</div></li><li class="half_rhythm"><div>(antigen? adj3 (analys* or assay* or immunoassay* or classif* or detect* or determin* or diagnos* or differenti* or identif* or method* or kit or kits or panel? or predict* or rapid or routine* or screen* or system* or technique* or test*)).tw,kf. 90890</div></li><li class="half_rhythm"><div>(RADT or RADTs or RDT or RDTs).tw,kf. 3331</div></li><li class="half_rhythm"><div>(rapid molecular or multiplex*).mp. 73203</div></li><li class="half_rhythm"><div>lab-on-a-chip.tw,kf. 3512</div></li><li class="half_rhythm"><div>((lateral flow adj (assay* or immunoassay* or test*)) or LFA or LFIA).tw,kf. 9990</div></li><li class="half_rhythm"><div>(immunochromatograph* or immuno-chromatograph* or immuno-chromato-graph* or direct immunofluorescence or direct immuno-fluorescence or enzym* immunoassay* or enzym* immuno-assay* or fluorescence immunoassay* or fluorescence immuno-assay* or optical immunoassay* or optical immuno-assay*).mp. or (ICA or EIA or FIA or OIA).tw,kf. 60476</div></li><li class="half_rhythm"><div>((chemiluminescen* or chemi-luminescen*) adj (immunoassay* or immuno-assay* or assay*)).mp. 4716</div></li><li class="half_rhythm"><div>(((mobile or portable or handheld or hand-held) adj3 (analy#er? or device? or meters or metres)) and (blood? or plasma or saliva or sputum or spit or mucus or urine or urea or urinalys* or fluids or gas or gases)).mp. 2614</div></li><li class="half_rhythm"><div>((biomarker* or procalcitonin* or PCT or “c reactive protein” or “c-reactive protein” or “C-reactive protein” or CRP or leucocyte or leukocyte or neutrophil* or white blood cell count* or wbc or wbcc or sodium or partial pressure of oxygen or partial pressure O2 or PaO2 or blood count or platelet count or CBC or FBC or blood exam* or blood test* or blood draw* or haematolog* or hematolog* or haemoglobin or hemoglobin or haematocrit or hematocrit or white blood cell or red blood cell or mean platelet volume or mean corpuscular volume or mean corpuscular haemoglobin or mean corpuscular hemaglobin or platelet* or basophil* or eosinophil* or lymphocyte* or monocyte* or erythrocyte*) adj3 (guid* or direct* or steer* or inform* or algorithm-guided or algorithm-directed or algorithm-steered or algorithm-informed)).tw,kf. 18753</div></li><li class="half_rhythm"><div>21 or 22 or 23 or 24 or 25 or 26 or 27 or 28 or 29 or 30 or 31 or 32 or 33 or 34 or 35 or 36 or 37 [Rapid Tests / biomarker guided management] 472216</div></li><li class="half_rhythm"><div>20 and 38 [RTIs / RTI Viral Infection / RTI Bacterial Infection AND Rapid Tests / biomarker guided management] 34240</div></li><li class="half_rhythm"><div>exp randomized controlled trial/ 594769</div></li><li class="half_rhythm"><div>controlled clinical trial.pt. 95314</div></li><li class="half_rhythm"><div>randomized.ab. 604126</div></li><li class="half_rhythm"><div>placebo.ab. 238387</div></li><li class="half_rhythm"><div>clinical trials as topic/ 200976</div></li><li class="half_rhythm"><div>randomly.ab. 408822</div></li><li class="half_rhythm"><div>trial.ti. 285699</div></li><li class="half_rhythm"><div>40 or 41 or 42 or 43 or 44 or 45 or 46 1525057</div></li><li class="half_rhythm"><div>exp animals/ not humans/ 5123796</div></li><li class="half_rhythm"><div>47 not 48 1403647</div></li><li class="half_rhythm"><div>randomized controlled trial.pt. 593242</div></li><li class="half_rhythm"><div>(random* or “controlled trial*” or “clinical trial*” or rct).tw. 1746752</div></li><li class="half_rhythm"><div>50 or 51 1865978</div></li><li class="half_rhythm"><div>39 and 49 1204</div></li><li class="half_rhythm"><div>39 and 52 1917</div></li><li class="half_rhythm"><div>53 or 54 2039</div></li><li class="half_rhythm"><div>limit 55 to english language 1959</div></li><li class="half_rhythm"><div>limit 56 to yr=“2022 -Current” 418</div></li><li class="half_rhythm"><div>limit 57 to (comment or editorial or letter or news) 2</div></li><li class="half_rhythm"><div>57 not 58 416</div></li></ol></div><div id="niceng237er2.app2.s2.3"><h5>Embase (Ovid)</h5><p>Searched: 28 May 2023</p><p>Embase Classic+Embase <1947 to 2023 May 25></p><ol><li class="half_rhythm"><div>respiratory tract infection/ or lower respiratory tract infection/ or chest infection/ or exp lung infection/ 360091</div></li><li class="half_rhythm"><div>exp bronchitis/ or common cold/ or mononucleosis/ or exp influenza/ or laryngitis/ or laryngotracheobronchitis/ or exp pharyngitis/ or exp pneumonia/ or severe acute respiratory syndrome/ or parainfluenza virus infection/ or sore throat/ or supraglottitis/ or tonsillitis/ or exp tracheitis/ 644599</div></li><li class="half_rhythm"><div>((airway* or bronchopulmonar* or broncho-pulmonar* or tracheobronch* or tracheo-bronch* or pulmonar* tract or pulmonary or respirat* tract or respiratory) adj3 (infect* or coinfect* or inflamm*)).tw,kf. 187030</div></li><li class="half_rhythm"><div>((chest or lung or lobar or pleura?) adj3 (absces* or infect* or coinfect* or inflamm*)).tw,kf. 62884</div></li><li class="half_rhythm"><div>(bronchit* or bronchopneumon* or common cold* or glandular fever or infectious mononucleosis or flu or influenza or laryngit* or laryngotracheobronchit* or laryngo tracheo bronchit* or laryngo tracheobronchit* or laryngotracheit* or nasopharyngit* or parainfluenza or pharyngit* or pneumoni* or pleuropneumoni* or rhinopharyngit* or severe acute respiratory syndrome or SARS or sore throat* or throat infection* or supraglottit* or supraglotit* or tonsillit* or tonsilit* or tracheit*).tw,kf. 731512</div></li><li class="half_rhythm"><div>((acute* or exacerbat* or flare*) adj3 (copd or coad or chronic obstructive pulmonary disease or chronic obstructive airway* disease or chronic obstructive lung disease)).mp. 19358</div></li><li class="half_rhythm"><div>((acute* or subacute* or exacerbat* or prolonged) adj3 cough*).mp. 2539</div></li><li class="half_rhythm"><div>(RTI or LRTI or URTI or ARTI or AURI or ALRI).tw,kf. 9587</div></li><li class="half_rhythm"><div>exp respiratory system/ and (exp virus/ or exp virus infection/) 61576</div></li><li class="half_rhythm"><div>exp virus pneumonia/ or exp *orthomyxovirus infection/ or exp influenza/ 146440</div></li><li class="half_rhythm"><div>((airway* or bronchopulmonar* or broncho-pulmonar* or tracheobronch* or tracheo-bronch* or pulmonar* tract or pulmonary or respirat* tract or respiratory) adj3 (nonbacter* or viral* or virus* or adenovir*)).tw,kf. 48349</div></li><li class="half_rhythm"><div>(rhinovir* or rhino* vir* or coryzavir* or coryza* vir* or influenzavir* or influenza* vir* or (H1N1 or H3N2) or parainfluenzavir* or parainfluenza* vir* or pneumovir* or pneumo* vir* or human metapneumovir* or human meta-pneumovir* or HMPV or respiratory syncytial vir*).mp. or RSV.tw,kf. 147895</div></li><li class="half_rhythm"><div>exp respiratory system/ and (exp bacterium/ or exp bacterial infection/) 92509</div></li><li class="half_rhythm"><div>exp bacterial pneumonia/ 38087</div></li><li class="half_rhythm"><div>((airway* or bronchopulmonar* or broncho-pulmonar* or tracheobronch* or tracheo-bronch* or pulmonar* tract or pulmonary or respirat* tract or respiratory) adj3 (bacter* or bacilli* or bacili* or corynebac* or mycobac* or nonvir* or pathogen*)).tw,kf. 31985</div></li><li class="half_rhythm"><div>(strep* pneumon* or diplococ* pneumon* or pneumococ* or staph* pneumon* or chlamyd* pneumon* or myco* pneumon* or influenza bacil* or bacteri* influenza* or h?emophil* influenza*).mp. 134619</div></li><li class="half_rhythm"><div>((strep* adj3 (throat* or pharyn* or tonsil*)) or (strep* and (airway* or pulmonary or brochopulmonar* or brocho-pulmonar* or respiratory*))).mp. 48594</div></li><li class="half_rhythm"><div>(GABHS or (“group a” adj3 strep*)).tw,kf. 14181</div></li><li class="half_rhythm"><div>strep* pyogen*.mp. 22698</div></li><li class="half_rhythm"><div>1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9 or 10 or 11 or 12 or 13 or 14 or 15 or 16 or 17 or 18 or 19 1474981</div></li><li class="half_rhythm"><div>point of care system/ 3810</div></li><li class="half_rhythm"><div>(POCT or POCTs or (((point adj2 care) or poc) adj3 (analys* or antigen or assay* or device? or immunoassay* or classif* or detect* or determin* or diagnos* or differenti* or identif* or method* or kit or kits or panel? or platform? or predict* or rapid or routine* or screen* or system* or technique* or test* or (cassette? or dipstick? or film* or stick or strip or fluorescent antibod*)))).tw,kf. 29715</div></li><li class="half_rhythm"><div>(point adj2 care).ti,kf. 20377</div></li><li class="half_rhythm"><div>(((near adj2 patient) or nearpatient or rapid* or bedside? or bed-side? or extra-laboratory or extralaboratory) adj3 (analys* or antigen? or assay* or immunoassay* or classif* or detect* or determin* or diagnos* or differenti* or identif* or method* or kit or kits or panel? or predict* or screen* or system* or technique* or test* or fluorescent antibod*)).tw,kf. 265872</div></li><li class="half_rhythm"><div>(((near adj2 patient) or nearpatient or bedside? or bed-side? or extra-laboratory or extralaboratory) adj3 rapid*).tw,kf. 961</div></li><li class="half_rhythm"><div>rapid test/ or influenza A rapid test/ or streptococcus group A rapid test/ 8381</div></li><li class="half_rhythm"><div>(rapid* adj3 (detect* or diagnos* or screen*)).tw,kf. 90602</div></li><li class="half_rhythm"><div>(time-to-result? or ((quick* or rapid* or short* or time*) adj3 (turnaround or turn-around))).tw,kf. 14966</div></li><li class="half_rhythm"><div>(antigen? adj3 (analys* or assay* or immunoassay* or classif* or detect* or determin* or diagnos* or differenti* or identif* or method* or kit or kits or panel? or predict* or rapid or routine* or screen* or system* or technique* or test*)).tw,kf. 123967</div></li><li class="half_rhythm"><div>(RADT or RADTs or RDT or RDTs).tw,kf. 5327</div></li><li class="half_rhythm"><div>(rapid molecular or multiplex*).mp. 115336</div></li><li class="half_rhythm"><div>lab-on-a-chip.tw,kf. 3683</div></li><li class="half_rhythm"><div>((lateral flow adj (assay* or immunoassay* or test*)) or LFA or LFIA).tw,kf. 11987</div></li><li class="half_rhythm"><div>(immunochromatograph* or immuno-chromatograph* or immuno-chromato-graph* or direct immunofluorescence or direct immuno-fluorescence or enzym* immunoassay* or enzym* immuno-assay* or fluorescence immunoassay* or fluorescence immuno-assay* or optical immunoassay* or optical immuno-assay*).mp. or (ICA or EIA or FIA or OIA).tw,kf. 111334</div></li><li class="half_rhythm"><div>((chemiluminescen* or chemi-luminescen*) adj (immunoassay* or immuno-assay* or assay*)).mp. 18319</div></li><li class="half_rhythm"><div>(((mobile or portable or handheld or hand-held) adj3 (analy#er? or device? or meters or metres)) and (blood? or plasma or saliva or sputum or spit or mucus or urine or urea or urinalys* or fluids or gas or gases)).mp. 4058</div></li><li class="half_rhythm"><div>((biomarker* or procalcitonin* or PCT or “c reactive protein” or “c-reactive protein” or “C-reactive protein” or CRP or leucocyte or leukocyte or neutrophil* or white blood cell count* or wbc or wbcc or sodium or partial pressure of oxygen or partial pressure O2 or PaO2 or blood count or platelet count or CBC or FBC or blood exam* or blood test* or blood draw* or haematolog* or hematolog* or haemoglobin or hemoglobin or haematocrit or hematocrit or white blood cell or red blood cell or mean platelet volume or mean corpuscular volume or mean corpuscular haemoglobin or mean corpuscular hemaglobin or platelet* or basophil* or eosinophil* or lymphocyte* or monocyte* or erythrocyte*) adj3 (guid* or direct* or steer* or inform* or algorithm-guided or algorithm-directed or algorithm-steered or algorithm-informed)).tw,kf. 29271</div></li><li class="half_rhythm"><div>21 or 22 or 23 or 24 or 25 or 26 or 27 or 28 or 29 or 30 or 31 or 32 or 33 or 34 or 35 or 36 or 37 682176</div></li><li class="half_rhythm"><div>37 and 20 1955</div></li><li class="half_rhythm"><div>exp randomized controlled trial/ 790418</div></li><li class="half_rhythm"><div>controlled clinical trial/ 469623</div></li><li class="half_rhythm"><div>random$.ti,ab. 1981362</div></li><li class="half_rhythm"><div>randomization/ 99460</div></li><li class="half_rhythm"><div>intermethod comparison/ 297400</div></li><li class="half_rhythm"><div>placebo.ti,ab. 371225</div></li><li class="half_rhythm"><div>(compare or compared or comparison).ti,ab. 7771662</div></li><li class="half_rhythm"><div>((evaluated or evaluate or evaluating or assessed or assess) and (compare or compared or comparing or comparison)).mp. [mp=title, abstract, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword heading word, floating subheading word, candidate term word] 2981040</div></li><li class="half_rhythm"><div>(open adj label).ti,ab. 109052</div></li><li class="half_rhythm"><div>((double or single or doubly or singly) adj (blind or blinded or blindly)).ti,ab. 280099</div></li><li class="half_rhythm"><div>double blind procedure/ 213168</div></li><li class="half_rhythm"><div>parallel group$1.ti,ab. 32267</div></li><li class="half_rhythm"><div>(crossover or cross over).ti,ab. 125950</div></li><li class="half_rhythm"><div>((assign$ or match or matched or allocation) adj5 (alternate or group$1 or intervention$1 or patient$1 or subject$1 or participant$1)).ti,ab. 417487</div></li><li class="half_rhythm"><div>(assigned or allocated).ti,ab. 491973</div></li><li class="half_rhythm"><div>(controlled adj7 (study or design or trial)).ti,ab. 454826</div></li><li class="half_rhythm"><div>(volunteer or volunteers).ti,ab. 288594</div></li><li class="half_rhythm"><div>human experiment/ 651776</div></li><li class="half_rhythm"><div>trial.ti. 411431</div></li><li class="half_rhythm"><div>or/40-58 10289233</div></li><li class="half_rhythm"><div>(random$ adj sampl$ adj7 (“cross section$” or questionnaire$1 or survey$ or database$1)).ti,ab. not (comparative study/ or controlled study/ or randomied controlled.ti,ab. or randomly assigned.ti,ab.) 9599</div></li><li class="half_rhythm"><div>cross-sectional study/ not (exp randomized controlled trial/ or controlled clinical trial/ or controlled study/ or randomi?ed controlled.ti,ab. or control group$1.ti,ab.) 347803</div></li><li class="half_rhythm"><div>((case adj control$).mp. and random$.ti,ab.) not randomi?ed controlled.ti,ab. [mp=title, abstract, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword heading word, floating subheading word, candidate term word] 26076</div></li><li class="half_rhythm"><div>systematic review.ti,ab. not (trial or study).ti. 326205</div></li><li class="half_rhythm"><div>(nonrandom$ not random$).ti,ab. 19058</div></li><li class="half_rhythm"><div>‘random field$’.ti,ab. 2951</div></li><li class="half_rhythm"><div>(random cluster adj3 sampl$).ti,ab. 1542</div></li><li class="half_rhythm"><div>(review.ab. and review.pt.) not trial.ti. 1117857</div></li><li class="half_rhythm"><div>“we searched”.ab. and (review.ti. or review.pt.) 49790</div></li><li class="half_rhythm"><div>“update review”.ab. 138</div></li><li class="half_rhythm"><div>(databases adj4 searched).ab. 62434</div></li><li class="half_rhythm"><div>(rat or rats or mouse or mice or swine or porcine or murine or sheep or lambs or pigs or piglets or rabbit or rabbits or cat or cats or dog or dogs or cattle or bovine or monkey or monkeys or trout or marmoset$1).ti. and animal experiment/ 1227348</div></li><li class="half_rhythm"><div>animal experiment/ not (human experiment/ or human/) 2581423</div></li><li class="half_rhythm"><div>or/60-72 4378964</div></li><li class="half_rhythm"><div>59 not 73 8989986</div></li><li class="half_rhythm"><div>39 and 74 681</div></li><li class="half_rhythm"><div>limit 75 to english language 672</div></li><li class="half_rhythm"><div>limit 76 to yr=“2022 -Current” 89</div></li><li class="half_rhythm"><div>limit 77 to (conference abstract or conference paper or “conference review” or editorial or letter) 20</div></li><li class="half_rhythm"><div>77 not 78 69</div></li></ol></div></div><div id="niceng237er2.app2.s3"><h4>Searches for cost-effectiveness</h4><div id="niceng237er2.app2.s3.1"><h5>MEDLINE (Ovid)</h5><p>Searched: 16 May 2023</p><p>Ovid MEDLINE(R) ALL <1946 to May 15, 2023></p><ol><li class="half_rhythm"><div>Respiratory Tract Infections/ 42626</div></li><li class="half_rhythm"><div>exp Bronchitis/ or Common Cold/ or Infectious Mononucleosis/ or Influenza, Human/ or Laryngitis/ or exp Pharyngitis/ or exp Pneumonia/ or Severe Acute Respiratory Syndrome/ 435829</div></li><li class="half_rhythm"><div>((airway* or bronchopulmonar* or broncho-pulmonar* or tracheobronch* or tracheo-bronch* or pulmonar* tract or pulmonary or respirat* tract or respiratory) adj3 (infect* or coinfect* or inflamm*)).tw,kf. 122748</div></li><li class="half_rhythm"><div>((chest or lung? or lobar or pleura?) adj3 (absces* or infect* or coinfect* or inflamm*)).tw,kf. 44790</div></li><li class="half_rhythm"><div>(bronchit* or bronchopneumon* or common cold* or glandular fever or infectious mononucleosis or flu or influenza or laryngit* or laryngotracheobronchit* or laryngo tracheo bronchit* or laryngo tracheobronchit* or laryngotracheit* or nasopharyngit* or parainfluenza or pharyngit* or pneumoni* or pleuropneumoni* or rhinopharyngit* or severe acute respiratory syndrome or SARS or sore throat* or throat infection* or supraglottit* or supraglotit* or tonsillit* or tonsilit* or tracheit*).tw,kf. 522522</div></li><li class="half_rhythm"><div>((acute* or exacerbat* or flare*) adj3 (copd or coad or chronic obstructive pulmonary disease or chronic obstructive airway* disease or chronic obstructive lung disease)).mp. 10295</div></li><li class="half_rhythm"><div>((acute* or subacute* or exacerbat* or prolonged) adj3 cough*).mp. 1546</div></li><li class="half_rhythm"><div>(RTI or LRTI or URTI or ARTI or AURI or ALRI).tw,kf. 6307</div></li><li class="half_rhythm"><div>exp Respiratory System/ and (exp Viruses/ or exp Virus Diseases/) 35000</div></li><li class="half_rhythm"><div>exp pneumonia, viral/ or *orthomyxoviridae infections/ or influenza, human/ 290911</div></li><li class="half_rhythm"><div>((airway* or bronchopulmonar* or broncho-pulmonar* or tracheobronch* or tracheo-bronch* or pulmonar* tract or pulmonary or respirat* tract or respiratory) adj3 (nonbacter* or viral* or virus* or adenovir*)).tw,kf. 35861</div></li><li class="half_rhythm"><div>(rhinovir* or rhino* vir* or coryzavir* or coryza* vir* or influenzavir* or influenza* vir* or (H1N1 or H3N2) or parainfluenzavir* or parainfluenza* vir* or pneumovir* or pneumo* vir* or human metapneumovir* or human meta-pneumovir* or HMPV or respiratory syncytial vir*).mp. or RSV.tw,kf. 138900</div></li><li class="half_rhythm"><div>exp Respiratory System/ and (exp Bacteria/ or exp Bacterial Infections/) 48073</div></li><li class="half_rhythm"><div>pneumonia, bacterial/ or chlamydial pneumonia/ or pneumonia, mycoplasma/ or pneumonia, pneumococcal/ or pneumonia, staphylococcal/ 22813</div></li><li class="half_rhythm"><div>((airway* or bronchopulmonar* or broncho-pulmonar* or tracheobronch* or tracheo-bronch* or pulmonar* tract or pulmonary or respirat* tract or respiratory) adj3 (bacter* or bacilli* or bacili* or corynebac* or mycobac* or nonvir* or pathogen*)).tw,kf. 22642</div></li><li class="half_rhythm"><div>(strep* pneumon* or diplococ* pneumon* or pneumococ* or staph* pneumon* or chlamyd* pneumon* or myco* pneumon* or influenza bacil* or bacteri* influenza* or h?emophil* influenza*).mp. 80781</div></li><li class="half_rhythm"><div>((strep* adj3 (throat* or pharyn* or tonsil*)) or (strep* and (airway* or pulmonary or brochopulmonar* or brocho-pulmonar* or respiratory*))).mp. 22162</div></li><li class="half_rhythm"><div>(GABHS or (“group a” adj3 strep*)).tw,kf. 10727</div></li><li class="half_rhythm"><div>strep* pyogen*.mp. 18540</div></li><li class="half_rhythm"><div>1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9 or 10 or 11 or 12 or 13 or 14 or 15 or 16 or 17 or 18 or 19 [RTIs / RTI Viral Infection / RTI Bacterial Infection] 961136</div></li><li class="half_rhythm"><div>Point-of-Care Systems/ 16387</div></li><li class="half_rhythm"><div>(POCT or POCTs or (((point adj2 care) or poc) adj3 (analys* or antigen? or assay* or device? or immunoassay* or classif* or detect* or determin* or diagnos* or differenti* or identif* or method* or kit or kits or panel? or platform? or predict* or rapid or routine* or screen* or system* or technique* or test* or (cassette? or dipstick? or film* or stick or strip or fluorescent antibod*)))).tw,kf. 21725</div></li><li class="half_rhythm"><div>(point adj2 care).ti,kf. 15063</div></li><li class="half_rhythm"><div>(((near adj2 patient) or nearpatient or rapid* or bedside? or bed-side? or extra-laboratory or extralaboratory) adj3 (analys* or antigen? or assay* or immunoassay* or classif* or detect* or determin* or diagnos* or differenti* or identif* or method* or kit or kits or panel? or predict* or screen* or system* or technique* or test* or fluorescent antibod*)).tw,kf. 204660</div></li><li class="half_rhythm"><div>(((near adj2 patient) or nearpatient or bedside? or bed-side? or extra-laboratory or extralaboratory) adj3 rapid*).tw,kf. 637</div></li><li class="half_rhythm"><div>Rapid Diagnostic Tests/ 43</div></li><li class="half_rhythm"><div>(rapid* adj3 (detect* or diagnos* or screen*)).tw,kf. 71754</div></li><li class="half_rhythm"><div>(time-to-result? or ((quick* or rapid* or short* or time*) adj3 (turnaround or turn-around))).tw,kf. 8119</div></li><li class="half_rhythm"><div>(antigen? adj3 (analys* or assay* or immunoassay* or classif* or detect* or determin* or diagnos* or differenti* or identif* or method* or kit or kits or panel? or predict* or rapid or routine* or screen* or system* or technique* or test*)).tw,kf. 90810</div></li><li class="half_rhythm"><div>(RADT or RADTs or RDT or RDTs).tw,kf. 3318</div></li><li class="half_rhythm"><div>(rapid molecular or multiplex*).mp. 73027</div></li><li class="half_rhythm"><div>lab-on-a-chip.tw,kf. 3504</div></li><li class="half_rhythm"><div>((lateral flow adj (assay* or immunoassay* or test*)) or LFA or LFIA).tw,kf. 9974</div></li><li class="half_rhythm"><div>(immunochromatograph* or immuno-chromatograph* or immuno-chromato-graph* or direct immunofluorescence or direct immuno-fluorescence or enzym* immunoassay* or enzym* immuno-assay* or fluorescence immunoassay* or fluorescence immuno-assay* or optical immunoassay* or optical immuno-assay*).mp. or (ICA or EIA or FIA or OIA).tw,kf. 60440</div></li><li class="half_rhythm"><div>((chemiluminescen* or chemi-luminescen*) adj (immunoassay* or immuno-assay* or assay*)).mp. 4700</div></li><li class="half_rhythm"><div>(((mobile or portable or handheld or hand-held) adj3 (analy#er? or device? or meters or metres)) and (blood? or plasma or saliva or sputum or spit or mucus or urine or urea or urinalys* or fluids or gas or gases)).mp. 2611</div></li><li class="half_rhythm"><div>21 or 22 or 23 or 24 or 25 or 26 or 27 or 28 or 29 or 30 or 31 or 32 or 33 or 34 or 35 or 36 [Rapid Tests] 453799</div></li><li class="half_rhythm"><div>20 and 37 [RTIs / RTI Viral Infection / RTI Bacterial Infection AND Rapid Tests] 33110</div></li><li class="half_rhythm"><div>exp Diagnosis/ 9337079</div></li><li class="half_rhythm"><div>di.fs. 2925815</div></li><li class="half_rhythm"><div>diagnos*.ti,ab,kf. 3041447</div></li><li class="half_rhythm"><div>(test or tests or testing).ti,ab,kf. 2837989</div></li><li class="half_rhythm"><div>39 or 40 or 41 or 42 [Diagnosis / Testing (broad)] 12968950</div></li><li class="half_rhythm"><div>20 and 43 [RTIs / RTI Viral Infection / RTI Bacterial Infection AND Diagnosis / Testing (broad)] 420239</div></li><li class="half_rhythm"><div>Cost-Benefit Analysis/ 92348</div></li><li class="half_rhythm"><div>(cost* and (((qualit* adj2 adjust*) and life*) or qaly*)).tw,kf. 17443</div></li><li class="half_rhythm"><div>((incremental* adj2 cost*) or ICER).tw,kf. 17647</div></li><li class="half_rhythm"><div>(cost adj2 utilit*).tw,kf. 7139</div></li><li class="half_rhythm"><div>(cost* and ((net adj benefit*) or ((net adj monetary) and benefit*) or ((net adj health) and benefit*))).tw,kf. 2345</div></li><li class="half_rhythm"><div>((cost adj2 effect*) and ((quality adj of) and life)).tw,kf. 12651</div></li><li class="half_rhythm"><div>(cost and (effect* or utilit*)).ti. 38213</div></li><li class="half_rhythm"><div>45 or 46 or 47 or 48 or 49 or 50 or 51 113868 [cost-utility filter – precise version - based on Hubbard et al 2022]</div></li><li class="half_rhythm"><div>38 and 52 203</div></li><li class="half_rhythm"><div>44 and 52 1292</div></li><li class="half_rhythm"><div>53 or 54 1301</div></li><li class="half_rhythm"><div>limit 55 to english language 1238</div></li><li class="half_rhythm"><div>limit 56 to (comment or editorial or letter or news or newspaper article) 56</div></li><li class="half_rhythm"><div>56 not 57 1182</div></li></ol></div><div id="niceng237er2.app2.s3.2"><h5>Embase (Ovid)</h5><p>Searched: 18 May 2023</p><p>Embase Classic+Embase <1947 to 2023 May 17></p><ol><li class="half_rhythm"><div>respiratory tract infection/ or lower respiratory tract infection/ or chest infection/ or exp lung infection/ 359718</div></li><li class="half_rhythm"><div>exp bronchitis/ or common cold/ or mononucleosis/ or exp influenza/ or laryngitis/ or laryngotracheobronchitis/ or exp pharyngitis/ or exp pneumonia/ or severe acute respiratory syndrome/ or parainfluenza virus infection/ or sore throat/ or supraglottitis/ or tonsillitis/ or exp tracheitis/ 643746</div></li><li class="half_rhythm"><div>((airway* or bronchopulmonar* or broncho-pulmonar* or tracheobronch* or tracheo-bronch* or pulmonar* tract or pulmonary or respirat* tract or respiratory) adj3 (infect* or coinfect* or inflamm*)).tw,kf. 186780</div></li><li class="half_rhythm"><div>((chest or lung or lobar or pleura?) adj3 (absces* or infect* or coinfect* or inflamm*)).tw,kf. 62801</div></li><li class="half_rhythm"><div>(bronchit* or bronchopneumon* or common cold* or glandular fever or infectious mononucleosis or flu or influenza or laryngit* or laryngotracheobronchit* or laryngo tracheo bronchit* or laryngo tracheobronchit* or laryngotracheit* or nasopharyngit* or parainfluenza or pharyngit* or pneumoni* or pleuropneumoni* or rhinopharyngit* or severe acute respiratory syndrome or SARS or sore throat* or throat infection* or supraglottit* or supraglotit* or tonsillit* or tonsilit* or tracheit*).tw,kf. 730007</div></li><li class="half_rhythm"><div>((acute* or exacerbat* or flare*) adj3 (copd or coad or chronic obstructive pulmonary disease or chronic obstructive airway* disease or chronic obstructive lung disease)).mp. 19331</div></li><li class="half_rhythm"><div>((acute* or subacute* or exacerbat* or prolonged) adj3 cough*).mp. 2536</div></li><li class="half_rhythm"><div>(RTI or LRTI or URTI or ARTI or AURI or ALRI).tw,kf. 9584</div></li><li class="half_rhythm"><div>exp respiratory system/ and (exp virus/ or exp virus infection/) 61466</div></li><li class="half_rhythm"><div>exp virus pneumonia/ or exp *orthomyxovirus infection/ or exp influenza/ 146242</div></li><li class="half_rhythm"><div>((airway* or bronchopulmonar* or broncho-pulmonar* or tracheobronch* or tracheo-bronch* or pulmonar* tract or pulmonary or respirat* tract or respiratory) adj3 (nonbacter* or viral* or virus* or adenovir*)).tw,kf. 48279</div></li><li class="half_rhythm"><div>(rhinovir* or rhino* vir* or coryzavir* or coryza* vir* or influenzavir* or influenza* vir* or (H1N1 or H3N2) or parainfluenzavir* or parainfluenza* vir* or pneumovir* or pneumo* vir* or human metapneumovir* or human meta-pneumovir* or HMPV or respiratory syncytial vir*).mp. or RSV.tw,kf. 147754</div></li><li class="half_rhythm"><div>exp respiratory system/ and (exp bacterium/ or exp bacterial infection/) 92429</div></li><li class="half_rhythm"><div>exp bacterial pneumonia/ 38054</div></li><li class="half_rhythm"><div>((airway* or bronchopulmonar* or broncho-pulmonar* or tracheobronch* or tracheo-bronch* or pulmonar* tract or pulmonary or respirat* tract or respiratory) adj3 (bacter* or bacilli* or bacili* or corynebac* or mycobac* or nonvir* or pathogen*)).tw,kf. 31947</div></li><li class="half_rhythm"><div>(strep* pneumon* or diplococ* pneumon* or pneumococ* or staph* pneumon* or chlamyd* pneumon* or myco* pneumon* or influenza bacil* or bacteri* influenza* or h?emophil* influenza*).mp. 134532</div></li><li class="half_rhythm"><div>((strep* adj3 (throat* or pharyn* or tonsil*)) or (strep* and (airway* or pulmonary or brochopulmonar* or brocho-pulmonar* or respiratory*))).mp. 48553</div></li><li class="half_rhythm"><div>(GABHS or (“group a” adj3 strep*)).tw,kf. 14167</div></li><li class="half_rhythm"><div>strep* pyogen*.mp. 22673</div></li><li class="half_rhythm"><div>1 or 2 or 3 or 4 or 5 or 6 or 7 or 8 or 9 or 10 or 11 or 12 or 13 or 14 or 15 or 16 or 17 or 18 or 19 [RTIs / RTI Viral Infection / RTI Bacterial Infection] 1472567</div></li><li class="half_rhythm"><div>point of care system/ 3800</div></li><li class="half_rhythm"><div>(POCT or POCTs or (((point adj2 care) or poc) adj3 (analys* or antigen or assay* or device? or immunoassay* or classif* or detect* or determin* or diagnos* or differenti* or identif* or method* or kit or kits or panel? or platform? or predict* or rapid or routine* or screen* or system* or technique* or test* or (cassette? or dipstick? or film* or stick or strip or fluorescent antibod*)))).tw,kf. 29627</div></li><li class="half_rhythm"><div>(point adj2 care).ti,kf. 20316</div></li><li class="half_rhythm"><div>(((near adj2 patient) or nearpatient or rapid* or bedside? or bed-side? or extra-laboratory or extralaboratory) adj3 (analys* or antigen? or assay* or immunoassay* or classif* or detect* or determin* or diagnos* or differenti* or identif* or method* or kit or kits or panel? or predict* or screen* or system* or technique* or test* or fluorescent antibod*)).tw,kf. 265505</div></li><li class="half_rhythm"><div>(((near adj2 patient) or nearpatient or bedside? or bed-side? or extra-laboratory or extralaboratory) adj3 rapid*).tw,kf. 957</div></li><li class="half_rhythm"><div>rapid test/ or influenza A rapid test/ or streptococcus group A rapid test/ 8357</div></li><li class="half_rhythm"><div>(rapid* adj3 (detect* or diagnos* or screen*)).tw,kf. 90455</div></li><li class="half_rhythm"><div>(time-to-result? or ((quick* or rapid* or short* or time*) adj3 (turnaround or turn-around))).tw,kf. 14929</div></li><li class="half_rhythm"><div>(antigen? adj3 (analys* or assay* or immunoassay* or classif* or detect* or determin* or diagnos* or differenti* or identif* or method* or kit or kits or panel? or predict* or rapid or routine* or screen* or system* or technique* or test*)).tw,kf. 123850</div></li><li class="half_rhythm"><div>(RADT or RADTs or RDT or RDTs).tw,kf. 5314</div></li><li class="half_rhythm"><div>(rapid molecular or multiplex*).mp. 115150</div></li><li class="half_rhythm"><div>lab-on-a-chip.tw,kf. 3675</div></li><li class="half_rhythm"><div>((lateral flow adj (assay* or immunoassay* or test*)) or LFA or LFIA).tw,kf. 11972</div></li><li class="half_rhythm"><div>(immunochromatograph* or immuno-chromatograph* or immuno-chromato-graph* or direct immunofluorescence or direct immuno-fluorescence or enzym* immunoassay* or enzym* immuno-assay* or fluorescence immunoassay* or fluorescence immuno-assay* or optical immunoassay* or optical immuno-assay*).mp. or (ICA or EIA or FIA or OIA).tw,kf. 111218</div></li><li class="half_rhythm"><div>((chemiluminescen* or chemi-luminescen*) adj (immunoassay* or immuno-assay* or assay*)).mp. 18247</div></li><li class="half_rhythm"><div>(((mobile or portable or handheld or hand-held) adj3 (analy#er? or device? or meters or metres)) and (blood? or plasma or saliva or sputum or spit or mucus or urine or urea or urinalys* or fluids or gas or gases)).mp. 4050</div></li><li class="half_rhythm"><div>21 or 22 or 23 or 24 or 25 or 26 or 27 or 28 or 29 or 30 or 31 or 32 or 33 or 34 or 35 or 36 [Rapid Tests] 653734</div></li><li class="half_rhythm"><div>20 and 37 [RTIs / RTI Viral Infection / RTI Bacterial Infection AND Rapid Tests] 53242</div></li><li class="half_rhythm"><div>exp diagnosis/ 8484048</div></li><li class="half_rhythm"><div>di.fs. 3725926</div></li><li class="half_rhythm"><div>diagnos*.ti,ab,kf. 4672696</div></li><li class="half_rhythm"><div>(test or tests or testing).ti,ab,kf. 4221212</div></li><li class="half_rhythm"><div>39 or 40 or 41 or 42 [Diagnosis / Testing (broad)] 13703963</div></li><li class="half_rhythm"><div>20 and 43 [RTIs / RTI Viral Infection / RTI Bacterial Infection AND Diagnosis / Testing (broad)] 649809</div></li><li class="half_rhythm"><div>cost utility analysis/ 12221</div></li><li class="half_rhythm"><div>(cost* and (((qualit* adj2 adjust*) and life*) or qaly*)).tw,kf. 30502</div></li><li class="half_rhythm"><div>((incremental* adj2 cost*) or ICER).tw,kf. 30673</div></li><li class="half_rhythm"><div>(cost adj2 utilit*).tw,kf. 11663</div></li><li class="half_rhythm"><div>(cost* and ((net adj benefit*) or ((net adj monetary) and benefit*) or ((net adj health) and benefit*))).tw,kf. 3360</div></li><li class="half_rhythm"><div>((cost adj2 effect*) and ((quality adj of) and life)).tw,kf. 19438</div></li><li class="half_rhythm"><div>(cost and (effect* or utilit*)).ti. 57091</div></li><li class="half_rhythm"><div>45 or 46 or 47 or 48 or 49 or 50 or 51 [cost-utility filter – precise version - based on Hubbard et al 2022] 91298</div></li><li class="half_rhythm"><div>38 and 52 186</div></li><li class="half_rhythm"><div>44 and 52 1108</div></li><li class="half_rhythm"><div>53 or 54 1121</div></li><li class="half_rhythm"><div>limit 55 to english language 1087</div></li><li class="half_rhythm"><div>limit 56 to (conference abstract or conference paper or “conference review” or editorial or letter) 261</div></li><li class="half_rhythm"><div>56 not 57 826</div></li></ol></div><div id="niceng237er2.app2.s3.3"><h5>CEA Registry</h5><p>
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<a href="https://cear.tuftsmedicalcenter.org/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://cear.tuftsmedicalcenter.org/</a>
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</p><p>Searched: 18 May 2023</p><p>Methods tab selected</p><dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>#1.</dt><dd><p class="no_top_margin">Keyword is: rapid and Disease (ICD-10) is: 10 [Diseases of the respiratory system (J00-J99)] = 19 articles</p></dd></dl><dl class="bkr_refwrap"><dt>#2.</dt><dd><p class="no_top_margin">Keyword is: point-of-care and Disease (ICD-10) is: 10 [Diseases of the respiratory system (J00-J99)] = 6 articles</p></dd></dl><dl class="bkr_refwrap"><dt>#3.</dt><dd><p class="no_top_margin">Keyword is: point of care and Disease (ICD-10) is: 10 [Diseases of the respiratory system (J00-J99)] = 15 articles</p></dd></dl><dl class="bkr_refwrap"><dt>#4.</dt><dd><p class="no_top_margin">Keyword is: bedside and Disease (ICD-10) is: 10 [Diseases of the respiratory system (J00-J99)] = 1 article</p></dd></dl><dl class="bkr_refwrap"><dt>#5.</dt><dd><p class="no_top_margin">Keyword is: near-patient and Disease (ICD-10) is: 10 [Diseases of the respiratory system (J00-J99)] = 1 article</p></dd></dl><dl class="bkr_refwrap"><dt>#6.</dt><dd><p class="no_top_margin">Keyword is: near patient and Disease (ICD-10) is: 10 [Diseases of the respiratory system (J00-J99)] = 3 articles</p></dd></dl><dl class="bkr_refwrap"><dt>#7.</dt><dd><p class="no_top_margin">Keyword is: extra-laboratory and Disease (ICD-10) is: 10 [Diseases of the respiratory system (J00-J99)] = 0 articles</p></dd></dl><dl class="bkr_refwrap"><dt>#8.</dt><dd><p class="no_top_margin">Keyword is: extra laboratory and Disease (ICD-10) is: 10 [Diseases of the respiratory system (J00-J99)] = 0 articles</p></dd></dl></dl><ul class="simple-list"><li class="half_rhythm"><div>Total: 45</div></li><li class="half_rhythm"><div>Total after duplicates removed: 35</div></li><li class="half_rhythm"><div>Total after duplicates found in MEDLINE or Embase removed: 17</div></li></ul></div></div></div><div id="niceng237er2.app3"><h3>Appendix 3. Study flow diagram: Systematic reviews of clinical effectiveness</h3><p id="niceng237er2.app3.et1"><a href="/books/NBK598986/bin/niceng237er2-app3-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (271K)</span></p><p><i>Modified from:</i>
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MJ, McKenzie
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JE, Bossuyt
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PM, Boutron
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I, Hoffmann
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TC, Mulrow
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CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ
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2021;372:n71. doi: 10.1136/bmj.n71
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[<a href="/pmc/articles/PMC8005924/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8005924</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/33782057" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33782057</span></a>] [<a href="http://dx.crossref.org/10.1136/bmj.n71" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</p></div><div id="niceng237er2.app4"><h3>Appendix 4. Excluded systematic reviews</h3><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng237er2app4tab1"><a href="/books/NBK598986/table/niceng237er2.app4.tab1/?report=objectonly" target="object" title="Table" class="img_link icnblk_img figpopup" rid-figpopup="figniceng237er2app4tab1" rid-ob="figobniceng237er2app4tab1"><img class="small-thumb" src="/books/NBK598986/table/niceng237er2.app4.tab1/?report=thumb" src-large="/books/NBK598986/table/niceng237er2.app4.tab1/?report=previmg" alt="Image " /></a><div class="icnblk_cntnt"><h4 id="niceng237er2.app4.tab1"><a href="/books/NBK598986/table/niceng237er2.app4.tab1/?report=objectonly" target="object" rid-ob="figobniceng237er2app4tab1">Table</a></h4></div></div></div><div id="niceng237er2.app5"><h3>Appendix 5. Study flow diagram: RCTs</h3><p id="niceng237er2.app5.et1"><a href="/books/NBK598986/bin/niceng237er2-app5-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (271K)</span></p><p><i>Modified from:</i>
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MJ, McKenzie
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JE, Bossuyt
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PM, Boutron
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I, Hoffmann
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TC, Mulrow
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CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ
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2021;372:n71. doi: 10.1136/bmj.n71
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[<a href="/pmc/articles/PMC8005924/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8005924</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/33782057" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33782057</span></a>] [<a href="http://dx.crossref.org/10.1136/bmj.n71" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]</p></div><div id="niceng237er2.app6"><h3>Appendix 6. Studies included in the clinical effectiveness review</h3><p id="niceng237er2.app6.et1"><a href="/books/NBK598986/bin/niceng237er2-app6-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 11. Included studies of C-reactive protein tests</a><span class="small"> (PDF, 391K)</span></p><p id="niceng237er2.app6.et2"><a href="/books/NBK598986/bin/niceng237er2-app6-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 12. Included studies of Procalcitonin tests</a><span class="small"> (PDF, 246K)</span></p><p id="niceng237er2.app6.et3"><a href="/books/NBK598986/bin/niceng237er2-app6-et3.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 13. Included studies of Group A Streptococcus tests</a><span class="small"> (PDF, 201K)</span></p><p id="niceng237er2.app6.et4"><a href="/books/NBK598986/bin/niceng237er2-app6-et4.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 14. Included studies of Influenza tests</a><span class="small"> (PDF, 226K)</span></p></div><div id="niceng237er2.app7"><h3>Appendix 7. Studies excluded from the clinical effectiveness review</h3><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figniceng237er2app7tab1"><a href="/books/NBK598986/table/niceng237er2.app7.tab1/?report=objectonly" target="object" title="Table" class="img_link icnblk_img figpopup" rid-figpopup="figniceng237er2app7tab1" rid-ob="figobniceng237er2app7tab1"><img class="small-thumb" src="/books/NBK598986/table/niceng237er2.app7.tab1/?report=thumb" src-large="/books/NBK598986/table/niceng237er2.app7.tab1/?report=previmg" alt="Image " /></a><div class="icnblk_cntnt"><h4 id="niceng237er2.app7.tab1"><a href="/books/NBK598986/table/niceng237er2.app7.tab1/?report=objectonly" target="object" rid-ob="figobniceng237er2app7tab1">Table</a></h4></div></div></div><div id="niceng237er2.app8"><h3>Appendix 8. Explanation of sample size adjustment</h3><p>An adjustment to the sample size must be made to cluster trials before they can be included in a meta-analysis with individually randomised trials. Instead of extracting this adjusted data from the Smedemark<a class="bibr" href="#niceng237er2.ref16" rid="niceng237er2.ref16"><sup>16</sup></a> review directly, we decided to also perform the calculations. We carried out this adjustment by dividing the total numbers in each arm and the event numbers in each arm by a quantity called the ‘design effect’, as advised in the Cochrane Handbook.<a class="bibr" href="#niceng237er2.ref17" rid="niceng237er2.ref17"><sup>17</sup></a> The design effect for each cluster randomised trial can be calculated using the below formula:
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<div class="pmc_disp_formula whole_rhythm clearfix" id="niceng237er2.app8.deq1"><div class="inline_block pmc_inline_block pmc_va_middle pmc_hide_overflow twelve_col"><math id="niceng237er2.app8.eq1" display="block"><mrow><mn>1</mn><mo>+</mo><mo stretchy="false">(</mo><mi>M</mi><mo>−</mo><mn>1</mn><mo stretchy="false">)</mo><mo>×</mo><mi>I</mi><mi>C</mi><mi>C</mi></mrow></math></div><div class="inline_block pmc_inline_block pmc_va_middle pmc_hide_overflow last bk_equ_label "><div><span class="nowrap"></span></div></div></div>
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where M is the average cluster size and ICC is the intracluster correlation coefficient. We estimated the average cluster size by dividing the total sample size by the number of clusters in each trial. We believe this is the same approach that the Smedemark authors followed.</p><p>After using the adjustment described above, our numbers differed slightly to those presented in the Smedemark review<a class="bibr" href="#niceng237er2.ref16" rid="niceng237er2.ref16"><sup>16</sup></a> for some trials.<a class="bibr" href="#niceng237er2.ref25" rid="niceng237er2.ref25"><sup>25</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref27" rid="niceng237er2.ref27"><sup>27</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref37" rid="niceng237er2.ref37"><sup>37</sup></a> Since the raw numbers extracted from primary studies are not presented in the said review, it is difficult to fully account for these differences. Here, we present values used in the calculation of the design effect, then we compare our adjusted sample sizes to those presented in Smedemark and discuss potential reasons for the discrepancies.</p><p id="niceng237er2.app8.et1"><a href="/books/NBK598986/bin/niceng237er2-app8-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 15. Numbers and event numbers in each arm for each included outcome and detail of information used to calculate the design effect</a><span class="small"> (PDF, 177K)</span></p><p id="niceng237er2.app8.et2"><a href="/books/NBK598986/bin/niceng237er2-app8-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 16. Adjusted sample size calculated using the design effect and the adjusted sample size numbers used in Smedemark review</a><span class="small"> (PDF, 176K)</span></p><p><a href="#niceng237er2.app8.et1">Table 15</a> shows the parameters used in the calculation of the design effect for each included study and outcome. <a href="#niceng237er2.app8.et2">Table 16</a> shows the adjusted sample size numbers we calculated and those presented in the Smedemark<a class="bibr" href="#niceng237er2.ref16" rid="niceng237er2.ref16"><sup>16</sup></a> review.</p><p>Andreeva<a class="bibr" href="#niceng237er2.ref29" rid="niceng237er2.ref29"><sup>29</sup></a> didn’t report the ICC value which means the design effect cannot be calculated. Smedemark<a class="bibr" href="#niceng237er2.ref16" rid="niceng237er2.ref16"><sup>16</sup></a> contacted the Andreeva<a class="bibr" href="#niceng237er2.ref29" rid="niceng237er2.ref29"><sup>29</sup></a> authors and obtained additional information. We presume they obtained the ICC value which allowed them to calculate the adjusted sample sizes presented in the review. The reivew also included two additonal outcomes (‘Number of re-consultations within 14 days’ and ‘Hospital admission (timeframe unclear)’) that were not presented in the Andreeva paper, which we assume were also obtained when the review authors contacted the Andreeva authors. Therefore, we used the adjusted numbers presented in the Smedemark review for the Andreeva study (see <a href="#niceng237er2.app8.et2">Table 16</a>).</p><p>The adjusted numbers that we calculated for Boere<a class="bibr" href="#niceng237er2.ref27" rid="niceng237er2.ref27"><sup>27</sup></a> are almost identical to the Smedemark review<a class="bibr" href="#niceng237er2.ref16" rid="niceng237er2.ref16"><sup>16</sup></a> (see <a href="#niceng237er2.app8.et2">Table 16</a>). There are small differences for outcomes ‘Hospital admission within 3 weeks’ and ‘Mortality rate within 3 weeks’, but we believe these are likely due to rounding and will have a negligble impact on the resulting meta-analysis. For this study, we included an additional outcome (‘Antibiotic use at index consultation; COPD patients’) that was not included in the review.</p><p>We noticed an inconsistency in the reported primary outcome numbers in Boere.<a class="bibr" href="#niceng237er2.ref27" rid="niceng237er2.ref27"><sup>27</sup></a> In the abstract, the paper reports n=84 patients prescribed antibiotics at index consultaiton in the C-reative protein (CRP) test group. However, <a href="#niceng237er2.app8.et2">Table 16</a> infers that this value should be 89 (73 antibiotic prescriptions avoided; 162-73=89). We believe Smedemark<a class="bibr" href="#niceng237er2.ref16" rid="niceng237er2.ref16"><sup>16</sup></a> used n=84 for the number of antibiotics prescribed at index consulation in the CRP group and we too chose to use this value.</p><p>Our calculated adjusted values match the numbers presented in Smedemark exactly for the Cals<a class="bibr" href="#niceng237er2.ref26" rid="niceng237er2.ref26"><sup>26</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref35" rid="niceng237er2.ref35"><sup>35</sup></a> study. Note however that the Cals paper reports an ICC of 0.01 for the outcome of ‘Number of re-consultations within 28 days’, which is different to the ICCs (0.12) for outcomes ‘Antibiotics prescribed at index consultation’ and ‘Antibiotics prescribed within 28 days’. We believe Smedemark used 0.12 in the adjustment of all outcomes. We obtained data for mortality and hospitalisation from the text in Cals (“no serious adverse events (death or admission to hospital) occurred”), meaning that there were no reported ICCs for these outcomes. Therefore, for consistency across all outcomes and with the Smedemark review, we chose to use an ICC of 0.12 for all outcomes from Cals. For the outcomes extracted from the text, we assumed the denominators were equal to those for the other reported outcomes (n=227 CRP group; n=204 ususal care group).</p><p>The Little<a class="bibr" href="#niceng237er2.ref25" rid="niceng237er2.ref25"><sup>25</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref37" rid="niceng237er2.ref37"><sup>37</sup></a> study used a 2x2 factorial design and randomised patients to one of four interventions: CRP test, usual care, CRP test with GP communication training and usual care with GP communication training. In the main analysis, the authors combined these four groups and adjusted for the effect of communication training. In other words, the CRP and CRP+communication training groups were combined, and the usual care and usual care+communicaiton training groups were combined, and the model adjusted for the effect of communication training. We believe the Smedemark<a class="bibr" href="#niceng237er2.ref16" rid="niceng237er2.ref16"><sup>16</sup></a> review used these combined numbers in the calculation of the adjusted sample size. However, since the raw numbers of these groups combined do not adjust for communication training, we decided to use the numbers for CRP test only versus usual care only and used the corresponding number of clusters for these groups. We extracted numbers from the supplementary data given in Little 2013<a class="bibr" href="#niceng237er2.ref25" rid="niceng237er2.ref25"><sup>25</sup></a> for ‘re-consultations for new or worse symptoms within 28 days’.</p><p>Further, we believe the authors of the Smedemark<a class="bibr" href="#niceng237er2.ref16" rid="niceng237er2.ref16"><sup>16</sup></a> review have incorrectly interpreted the timescale of the primary outcome. The timeframe for the primary outcome (antibiotic prescribing) is unclear from the Little 2013<a class="bibr" href="#niceng237er2.ref25" rid="niceng237er2.ref25"><sup>25</sup></a> paper. Smedemark believe that the primary outcome refers to ‘Antibiotics prescribed at index consultation’. However, we believe that this outcome actually reflects the antibiotics prescribed within 3 months. This is clearer in the Little 2019<a class="bibr" href="#niceng237er2.ref37" rid="niceng237er2.ref37"><sup>37</sup></a> publication. The authors state that in the usual care group “58% (508 of 870) were prescribed antibiotics at 3 months” and in the CRP group “(368 of 1,062) at 3 months”. These values match those presented in the Little 2013<a class="bibr" href="#niceng237er2.ref25" rid="niceng237er2.ref25"><sup>25</sup></a> publication supplementary material. We therefore exclude Little 2013<a class="bibr" href="#niceng237er2.ref25" rid="niceng237er2.ref25"><sup>25</sup></a> from our meta-analysis of antibiotic use at index consultation.</p><p>In addition, we believe Smedemark<a class="bibr" href="#niceng237er2.ref16" rid="niceng237er2.ref16"><sup>16</sup></a> used an ICC of 0.08 in their calculations. However, we chose to use an ICC of 0.05 since this ICC controls for baseline antibiotic prescribing (see supplementary material Little 2013<a class="bibr" href="#niceng237er2.ref25" rid="niceng237er2.ref25"><sup>25</sup></a>). Finally, we extracted data for outcomes ‘Hospital admissions (timeframe unclear)’ and ‘Mortality (timeframe unclear)’ from the text of Little 2013<a class="bibr" href="#niceng237er2.ref25" rid="niceng237er2.ref25"><sup>25</sup></a> (“30 patients were reported as being admitted to hospital (two in the usual-care group, ten in the CRP group”; “No patients died”). We assumed the denominators were the same as at the beginning of the study (n=1062 CRP group; n=870 usual care group).</p><p>These reasons combined explain the marked differences in the adjusted sample sizes for the Little<a class="bibr" href="#niceng237er2.ref25" rid="niceng237er2.ref25"><sup>25</sup></a><sup>,</sup>
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<a class="bibr" href="#niceng237er2.ref37" rid="niceng237er2.ref37"><sup>37</sup></a> study. No additional outcome data was obtained from the Little 2019<a class="bibr" href="#niceng237er2.ref37" rid="niceng237er2.ref37"><sup>37</sup></a> publication.</p></div><div id="niceng237er2.app9"><h3>Appendix 9. Quality assessment of included RCTs</h3><p id="niceng237er2.app9.et1"><a href="/books/NBK598986/bin/niceng237er2-app9-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 17. Risk of bias: C-reactive protein tests</a><span class="small"> (PDF, 189K)</span></p><p id="niceng237er2.app9.et2"><a href="/books/NBK598986/bin/niceng237er2-app9-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 18. Risk of bias: procalcitonin tests</a><span class="small"> (PDF, 179K)</span></p><p id="niceng237er2.app9.et3"><a href="/books/NBK598986/bin/niceng237er2-app9-et3.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 19. Risk of bias: Group A streptococcus tests</a><span class="small"> (PDF, 185K)</span></p><p id="niceng237er2.app9.et4"><a href="/books/NBK598986/bin/niceng237er2-app9-et4.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 20. Risk of bias: influenza tests</a><span class="small"> (PDF, 194K)</span></p><p id="niceng237er2.app9.et5"><a href="/books/NBK598986/bin/niceng237er2-app9-et5.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 21. Justification for risk of bias judgements</a><span class="small"> (PDF, 251K)</span></p></div><div id="niceng237er2.app10"><h3>Appendix 10. GRADE tables</h3><p>GRADE evidence tables are presented below for C-reactive protein, procalcitonin and influenza rapid antigen tests. No evidence for the relevant outcomes was identified for Group A streptococcus rapid antigen tests.</p><p id="niceng237er2.app10.et1"><a href="/books/NBK598986/bin/niceng237er2-app10-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 22. Clinical evidence profile for comparison of C-reactive POCT versus usual care in adults with suspected ARI</a><span class="small"> (PDF, 266K)</span></p><p id="niceng237er2.app10.et2"><a href="/books/NBK598986/bin/niceng237er2-app10-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 23. Clinical evidence profile for comparison of procalcitonin POCT versus usual care in adults with suspected ARI</a><span class="small"> (PDF, 259K)</span></p><p id="niceng237er2.app10.et3"><a href="/books/NBK598986/bin/niceng237er2-app10-et3.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 24. Clinical evidence profile for comparison of rapid antigen tests for influenza versus usual care in adults with suspected ARI</a><span class="small"> (PDF, 256K)</span></p></div><div id="niceng237er2.app11"><h3>Appendix 11. Subgroup and sensitivity analyses for clinical effectiveness outcomes</h3><p id="niceng237er2.app11.et1"><a href="/books/NBK598986/bin/niceng237er2-app11-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (251K)</span></p></div><div id="niceng237er2.app12"><h3>Appendix 12. Critical appraisal of included systematic reviews of cost-effectiveness studies</h3><p id="niceng237er2.app12.et1"><a href="/books/NBK598986/bin/niceng237er2-app12-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (216K)</span></p></div><div id="niceng237er2.app13"><h3>Appendix 13. References of excluded studies at full texts and primary reason for exclusion</h3><p id="niceng237er2.app13.et1"><a href="/books/NBK598986/bin/niceng237er2-app13-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (209K)</span></p></div><div id="niceng237er2.app14"><h3>Appendix 14. Applicability of included cost utility studies to our review question</h3><p id="niceng237er2.app14.et1"><a href="/books/NBK598986/bin/niceng237er2-app14-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (310K)</span></p></div></div></div><div class="fm-sec"><div><p>FINAL</p></div><div><p>
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<b>Disclosure of Interests Statement</b>
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</p><p>Professor Daniel Lasserson undertook a service evaluation (not funded by the companies) of Abbott and Afinion point of care tests and other point of care test research studies funded by the Health Foundation or through core NIHR infrastructure awards. No potential conflict of interests was declared by other authors.</p><p>Evidence review underpinning the recommendations and recommendations for research in the NICE guideline</p><p>This evidence review was developed by the West Midlands Evidence Synthesis Group</p></div><div><b>Funding:</b> This project was funded by the NIHR Evidence Synthesis Programme, Project number NIHR159946.</div><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>*</dt><dd><div id="niceng237er2.fn1"><p class="no_top_margin">Corresponding author</p></div></dd></dl></dl></div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © 2023 Scandrett et al. This work was produced by Scandrett et al. (West Midlands Evidence Synthesis Group) under the terms of a commissioning contract issued by the Secretary of State for Health and Social Care and has been submitted for publication in the NIHR Journals Library.</div><div class="small"><span class="label">Bookshelf ID: NBK598986</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/38170807" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">38170807</a></span></div></div><div class="small-screen-prev"></div><div class="small-screen-next"></div></article><article data-type="table-wrap" id="figobniceng237er2tab1"><div id="niceng237er2.tab1" class="table"><h3><span class="label">Table 1</span><span class="title">Characteriscs of included studies for C-reacve protein point of care tests</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK598986/table/niceng237er2.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng237er2.tab1_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng237er2.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study Details</th><th id="hd_h_niceng237er2.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Participants</th><th id="hd_h_niceng237er2.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interventions</th><th id="hd_h_niceng237er2.tab1_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><th id="hd_h_niceng237er2.tab1_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments<sup>a</sup></th></tr></thead><tbody><tr><th headers="hd_h_niceng237er2.tab1_1_1_1_1 hd_h_niceng237er2.tab1_1_1_1_2 hd_h_niceng237er2.tab1_1_1_1_3 hd_h_niceng237er2.tab1_1_1_1_4 hd_h_niceng237er2.tab1_1_1_1_5" id="hd_b_niceng237er2.tab1_1_1_1_1" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">Afinion CRP point-of-care testing</th></tr><tr><td headers="hd_h_niceng237er2.tab1_1_1_1_1 hd_b_niceng237er2.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Andreeva 2014<a class="bibr" href="#niceng237er2.ref29" rid="niceng237er2.ref29"><sup>29</sup></a></p>
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<p>Russia</p>
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<p>Open-label cluster RCT</p>
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<p>January to April 2010</p>
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<p><b>Follow-up:</b> 14 days</p>
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</td><td headers="hd_h_niceng237er2.tab1_1_1_1_2 hd_b_niceng237er2.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>179 patients: CRP 101, usual care 78</p>
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<p>Acute cough/lower RTI for < 28 days</p>
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</td><td headers="hd_h_niceng237er2.tab1_1_1_1_3 hd_b_niceng237er2.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p><b>Interventions</b>: Single POC CRP</p>
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<p><b>Comparator</b>: usual care</p>
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</td><td headers="hd_h_niceng237er2.tab1_1_1_1_4 hd_b_niceng237er2.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Antibiotics prescribed at index consultation</div></li><li class="half_rhythm"><div>Antibiotics prescribed within 14 days</div></li><li class="half_rhythm"><div>Hospital admission (not stated, assume within 14 days)</div></li><li class="half_rhythm"><div>Number of re-consultations within 14 days</div></li><li class="half_rhythm"><div>Number of participants fully or almost recovered within 14 days</div></li></ul>
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</td><td headers="hd_h_niceng237er2.tab1_1_1_1_5 hd_b_niceng237er2.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Funding<i>:</i> Not reported. Test kits provided by manufacturer and CRP readers acquired at reduced prices.</p>
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<p>Overall risk of bias: High</p>
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</td></tr><tr><td headers="hd_h_niceng237er2.tab1_1_1_1_1 hd_b_niceng237er2.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Butler 2019<a class="bibr" href="#niceng237er2.ref24" rid="niceng237er2.ref24"><sup>24</sup></a> Francis 2020<a class="bibr" href="#niceng237er2.ref34" rid="niceng237er2.ref34"><sup>34</sup></a></p>
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<p>UK (England & Wales)</p>
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<p>Open-label RCT</p>
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<p>January 2015 to September 2017</p>
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<p><b>Follow-up:</b> 4 weeks and 6 months</p>
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</td><td headers="hd_h_niceng237er2.tab1_1_1_1_2 hd_b_niceng237er2.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>649 patients: CRP 325, usual care 324</p>
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<p>Acute exacerbation of COPD between 24 hours and 21 days duration</p>
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</td><td headers="hd_h_niceng237er2.tab1_1_1_1_3 hd_b_niceng237er2.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p><b>Interventions</b>: Single POC CRP</p>
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<p><b>Comparator</b>: usual care</p>
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</td><td headers="hd_h_niceng237er2.tab1_1_1_1_4 hd_b_niceng237er2.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Antibiotics prescribed at index consultation</div></li><li class="half_rhythm"><div>Antibiotics prescribed within 28 days</div></li><li class="half_rhythm"><div>Antibiotics prescribed within 4 weeks post-randomisation (patient-reported)</div></li><li class="half_rhythm"><div>Mortality within 28 days</div></li><li class="half_rhythm"><div>Hospital admissions within 6 months</div></li><li class="half_rhythm"><div>Primary and/or secondary care consultations during 6 months follow-up</div></li><li class="half_rhythm"><div>HRQoL (EQ-5D-5L index value) at 1, 2 and 4 weeks and at 6 months</div></li><li class="half_rhythm"><div>HRQoL (EQ-5D-5L health status) at 1, 2 and 4 weeks and at 6 months</div></li><li class="half_rhythm"><div>HRQoL (CRQ-SAS)</div></li></ul>
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</td><td headers="hd_h_niceng237er2.tab1_1_1_1_5 hd_b_niceng237er2.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Funding: Non-commercial</p>
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<p>Overall risk of bias: High</p>
|
|
</td></tr><tr><th headers="hd_h_niceng237er2.tab1_1_1_1_1 hd_h_niceng237er2.tab1_1_1_1_2 hd_h_niceng237er2.tab1_1_1_1_3 hd_h_niceng237er2.tab1_1_1_1_4 hd_h_niceng237er2.tab1_1_1_1_5" id="hd_b_niceng237er2.tab1_1_1_4_1" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">Nycocard II CRP point-of-care testing <i>(Not currently available in the UK)</i></th></tr><tr><td headers="hd_h_niceng237er2.tab1_1_1_1_1 hd_b_niceng237er2.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Althaus 2019<a class="bibr" href="#niceng237er2.ref30" rid="niceng237er2.ref30"><sup>30</sup></a></p>
|
|
<p>Thailand and Myanmar</p>
|
|
<p>Open-label RCT</p>
|
|
<p>June 2016 to June 2017</p>
|
|
<p><b>Follow-up:</b> Day 5 + 14</p>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_2 hd_b_niceng237er2.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>937 patients (adults subgroup) CRP 614, usual care 323</p>
|
|
<p>Documented fever or chief complaint of fever (< 14 days)</p>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_3 hd_b_niceng237er2.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Interventions</b>: Single POC CRP</p>
|
|
<p><b>Comparator</b>: usual care</p>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_4 hd_b_niceng237er2.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul><li class="half_rhythm"><div>Antibiotics prescribed at index consultation</div></li></ul>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_5 hd_b_niceng237er2.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Funding: Noncommercial</p>
|
|
<p>Overall risk of bias: High</p>
|
|
</td></tr><tr><td headers="hd_h_niceng237er2.tab1_1_1_1_1 hd_b_niceng237er2.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Cals 2009<a class="bibr" href="#niceng237er2.ref26" rid="niceng237er2.ref26"><sup>26</sup></a></p>
|
|
<p>Cals 2013<a class="bibr" href="#niceng237er2.ref35" rid="niceng237er2.ref35"><sup>35</sup></a></p>
|
|
<p>The Netherlands</p>
|
|
<p>Open-label cluster-RCT</p>
|
|
<p>Winter periods 2005-06 and 2006-07</p>
|
|
<p><b>Follow-up:</b> 28 days</p>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_2 hd_b_niceng237er2.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>431 patients CRP 227, usual care 204</p>
|
|
<p>Suspected lower respiratory tract infection</p>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_3 hd_b_niceng237er2.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Interventions</b>: Single POC CRP</p>
|
|
<p><b>Comparator</b>: usual care</p>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_4 hd_b_niceng237er2.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul><li class="half_rhythm"><div>Antibiotics prescribed at index consultation</div></li><li class="half_rhythm"><div>Antibiotics prescribed within 28 days</div></li><li class="half_rhythm"><div>Mortality during 28 days</div></li><li class="half_rhythm"><div>Hospital admissions during 28 days</div></li><li class="half_rhythm"><div>Number of re-consultations within 28 days</div></li><li class="half_rhythm"><div>Number of participants substantially improved within 28 days</div></li></ul>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_5 hd_b_niceng237er2.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Funding: Non-commercial</p>
|
|
<p>Overall risk of bias: High</p>
|
|
</td></tr><tr><td headers="hd_h_niceng237er2.tab1_1_1_1_1 hd_b_niceng237er2.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Diederichsen 2000<a class="bibr" href="#niceng237er2.ref31" rid="niceng237er2.ref31"><sup>31</sup></a></p>
|
|
<p>Denmark</p>
|
|
<p>Open-label RCT</p>
|
|
<p>January to April 1997</p>
|
|
<p><b>Follow-up:</b> 1 week</p>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_2 hd_b_niceng237er2.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>673 patients CRP 342, usual care 331</p>
|
|
<p>All patients with index case of respiratory infection</p>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_3 hd_b_niceng237er2.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Interventions</b>: Single POC CRP</p>
|
|
<p><b>Comparator</b>: usual care</p>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_4 hd_b_niceng237er2.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul><li class="half_rhythm"><div>Antibiotics prescribed at index consultation</div></li></ul>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_5 hd_b_niceng237er2.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Source of funding: Not reported</p>
|
|
<p>Overall risk of bias: High</p>
|
|
</td></tr><tr><td headers="hd_h_niceng237er2.tab1_1_1_1_1 hd_b_niceng237er2.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Do 2016<a class="bibr" href="#niceng237er2.ref33" rid="niceng237er2.ref33"><sup>33</sup></a></p>
|
|
<p>Northern Vietnam</p>
|
|
<p>Open-label RCT</p>
|
|
<p>March 2014 to July 2015</p>
|
|
<p><b>Follow-up:</b> 14 days</p>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_2 hd_b_niceng237er2.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1008 patients CRP 507, usual care 501</p>
|
|
<p>Non-severe acute respiratory tract infection</p>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_3 hd_b_niceng237er2.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Interventions</b>: Single POC CRP</p>
|
|
<p><b>Comparator</b>: usual care</p>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_4 hd_b_niceng237er2.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul><li class="half_rhythm"><div>Antibiotics prescribed at index consultation</div></li><li class="half_rhythm"><div>Antibiotics prescribed within 14 days (per protocol analysis)</div></li><li class="half_rhythm"><div>Subsequent antibiotic use in those without an immediate antibiotic prescription</div></li><li class="half_rhythm"><div>Antibiotic management change in those without an immediate antibiotic prescription</div></li><li class="half_rhythm"><div>Time to resolution of symptoms</div></li><li class="half_rhythm"><div>Mortality within 14 days</div></li></ul>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_5 hd_b_niceng237er2.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Funding: Non-commercial</p>
|
|
<p>Overall risk of bias: High</p>
|
|
</td></tr><tr><td headers="hd_h_niceng237er2.tab1_1_1_1_1 hd_b_niceng237er2.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Melbye 1995<a class="bibr" href="#niceng237er2.ref32" rid="niceng237er2.ref32"><sup>32</sup></a></p>
|
|
<p>Norway</p>
|
|
<p>Open-label RCT</p>
|
|
<p>Study dates not reported</p>
|
|
<p><b>Follow-up:</b> 3 weeks</p>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_2 hd_b_niceng237er2.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>239 patients CRP 108, usual care 131</p>
|
|
<p>Suspected lower RTI</p>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_3 hd_b_niceng237er2.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Interventions</b>: Single POC CRP</p>
|
|
<p><b>Comparator</b>: usual care</p>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_4 hd_b_niceng237er2.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul><li class="half_rhythm"><div>Antibiotics prescribed at index consultation</div></li><li class="half_rhythm"><div>Antibiotics prescribed within 28 days</div></li><li class="half_rhythm"><div>Number of participants substantially improved within 7 days</div></li><li class="half_rhythm"><div>Number of participants substantially improved within 28 days</div></li></ul>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_5 hd_b_niceng237er2.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Funding: Nycomed Pharma</p>
|
|
<p>Study terminated early due to parity at interim analysis and lack of interest in participating practices.</p>
|
|
<p>Overall risk of bias: High</p>
|
|
</td></tr><tr><th headers="hd_h_niceng237er2.tab1_1_1_1_1 hd_h_niceng237er2.tab1_1_1_1_2 hd_h_niceng237er2.tab1_1_1_1_3 hd_h_niceng237er2.tab1_1_1_1_4 hd_h_niceng237er2.tab1_1_1_1_5" id="hd_b_niceng237er2.tab1_1_1_10_1" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">QuikRead CRP</th></tr><tr><td headers="hd_h_niceng237er2.tab1_1_1_1_1 hd_b_niceng237er2.tab1_1_1_10_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Boere 2021<a class="bibr" href="#niceng237er2.ref27" rid="niceng237er2.ref27"><sup>27</sup></a></p>
|
|
<p>Boere 2022<a class="bibr" href="#niceng237er2.ref36" rid="niceng237er2.ref36"><sup>36</sup></a></p>
|
|
<p>The Netherlands</p>
|
|
<p>Open-label cluster RCT</p>
|
|
<p>September 2018 to March 2020</p>
|
|
<p><b>Follow-up:</b> 3 weeks</p>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_2 hd_b_niceng237er2.tab1_1_1_10_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>241 patients CRP 162, usual care 79</p>
|
|
<p>Nursing home residents with suspected LRTI</p>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_3 hd_b_niceng237er2.tab1_1_1_10_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Interventions</b>: Single POC CRP</p>
|
|
<p><b>Comparator</b>: usual care</p>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_4 hd_b_niceng237er2.tab1_1_1_10_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul><li class="half_rhythm"><div>Antibiotics prescribed at index consultation (including subgroup analysis for COPD)</div></li><li class="half_rhythm"><div>Antibiotic treatment changes (start, cessation, switch, or prolongation)</div></li><li class="half_rhythm"><div>Mortality within 3 weeks</div></li><li class="half_rhythm"><div>Hospital admission within 3 weeks</div></li><li class="half_rhythm"><div>Hospitalisation at initial consultation</div></li><li class="half_rhythm"><div>Hospitalisation at 1 and 3 weeks</div></li><li class="half_rhythm"><div>Number of participants substantially improved within 3 weeks</div></li><li class="half_rhythm"><div>Number of participants fully recovered at 3 weeks</div></li></ul>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_5 hd_b_niceng237er2.tab1_1_1_10_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Funding: Non-commercial</p>
|
|
<p>Overall risk of bias: High</p>
|
|
</td></tr><tr><td headers="hd_h_niceng237er2.tab1_1_1_1_1 hd_b_niceng237er2.tab1_1_1_10_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Cals 2010<a class="bibr" href="#niceng237er2.ref28" rid="niceng237er2.ref28"><sup>28</sup></a></p>
|
|
<p>The Netherlands</p>
|
|
<p>Open-label RCT</p>
|
|
<p>November 2007 to April 2008</p>
|
|
<p><b>Follow-up:</b> 28 days</p>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_2 hd_b_niceng237er2.tab1_1_1_10_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>258 patients CRP 129, usual care 129</p>
|
|
<p>Suspected acute LRTI or rhinosinusitis</p>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_3 hd_b_niceng237er2.tab1_1_1_10_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Interventions</b>: Single POC CRP</p>
|
|
<p><b>Comparator</b>: usual care</p>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_4 hd_b_niceng237er2.tab1_1_1_10_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul><li class="half_rhythm"><div>Antibiotics use after index consultation (immediate prescription and/or delayed prescription and filled)</div></li><li class="half_rhythm"><div>Antibiotics prescribed within 28 days</div></li><li class="half_rhythm"><div>Mortality within 28 days</div></li><li class="half_rhythm"><div>Hospital admissions within 28 days</div></li><li class="half_rhythm"><div>Number of re-consultations within 28 days</div></li><li class="half_rhythm"><div>Number of participants substantially improved within 7 days</div></li><li class="half_rhythm"><div>Patient reported time to full recovery</div></li></ul>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_5 hd_b_niceng237er2.tab1_1_1_10_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Funding: Orion Diagnostica Espoo, Finland</p>
|
|
<p>Overall risk of bias: High</p>
|
|
</td></tr><tr><td headers="hd_h_niceng237er2.tab1_1_1_1_1 hd_b_niceng237er2.tab1_1_1_10_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Little 2013<a class="bibr" href="#niceng237er2.ref25" rid="niceng237er2.ref25"><sup>25</sup></a> Little 2019<a class="bibr" href="#niceng237er2.ref37" rid="niceng237er2.ref37"><sup>37</sup></a></p>
|
|
<p>Belgium, UK, Poland, Spain, The Netherlands</p>
|
|
<p>Open-label cluster-RCT</p>
|
|
<p>February 2011 to May 2012</p>
|
|
<p><b>Follow-up:</b> 12 months</p>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_2 hd_b_niceng237er2.tab1_1_1_10_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>1932 patients CRP 1062, usual care 870</p>
|
|
<p>Upper or lower respiratory tract infection</p>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_3 hd_b_niceng237er2.tab1_1_1_10_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Interventions</b>: Single POC CRP</p>
|
|
<p><b>Comparator</b>: usual care</p>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_4 hd_b_niceng237er2.tab1_1_1_10_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul><li class="half_rhythm"><div>Hospital admissions within 4 weeks</div></li><li class="half_rhythm"><div>Number of re-consultations within 28 days</div></li><li class="half_rhythm"><div>Resolution of moderately bad symptoms,</div></li><li class="half_rhythm"><div>Mortality</div></li></ul>
|
|
</td><td headers="hd_h_niceng237er2.tab1_1_1_1_5 hd_b_niceng237er2.tab1_1_1_10_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Funding: Noncommercial</p>
|
|
<p>Overall risk of bias: High</p>
|
|
</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng237er2.tab1_1"><p class="no_margin">Overall risk of bias: see <a href="#niceng237er2.app9">Appendix 9</a> for details. Abbreviations: AECOPD – acute exacerbation of chronic obstructive pulmonary disease; ARI – acute respiratory infection; COPD – chronic obstructive pulmonary disease; CRP – C-reactive protein; CRQ-SAS - Chronic Respiratory Disease Questionnaire; EQ-5D-5L - European Quality of Life–5 Dimensions 5-Level questionnaire; GP – general practice; POC – point-of-care; RCT – randomised controlled trial; RTI – respiratory tract infection.</p></div></dd></dl></dl></div></div></div></article><article data-type="fig" id="figobniceng237er2fig1"><div id="niceng237er2.fig1" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%201.%20CRP%20POCT%20vs%20usual%20care%20-%20Hospital%20Admission.&p=BOOKS&id=598986_niceng237er2f1.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK598986/bin/niceng237er2f1.jpg" alt="Figure 1. CRP POCT vs usual care - Hospital Admission." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 1</span><span class="title">CRP POCT vs usual care - Hospital Admission</span></h3></div></article><article data-type="fig" id="figobniceng237er2fig2"><div id="niceng237er2.fig2" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%202.%20CRP%20POCT%20vs%20usual%20care%20-%20Escalation%20of%20care%3A%20number%20of%20re-consultations.&p=BOOKS&id=598986_niceng237er2f2.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK598986/bin/niceng237er2f2.jpg" alt="Figure 2. CRP POCT vs usual care - Escalation of care: number of re-consultations." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 2</span><span class="title">CRP POCT vs usual care - Escalation of care: number of re-consultations</span></h3></div></article><article data-type="fig" id="figobniceng237er2fig3"><div id="niceng237er2.fig3" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%203.%20CRP%20POCT%20vs%20usual%20care%20-%20Antibiotics%20prescribed%20at%20index%20consultation.&p=BOOKS&id=598986_niceng237er2f3.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK598986/bin/niceng237er2f3.jpg" alt="Figure 3. CRP POCT vs usual care - Antibiotics prescribed at index consultation." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 3</span><span class="title">CRP POCT vs usual care - Antibiotics prescribed at index consultation</span></h3></div></article><article data-type="fig" id="figobniceng237er2fig4"><div id="niceng237er2.fig4" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%204.%20CRP%20POCT%20vs%20usual%20care%20-%20Antibiotics%20prescribed%20within%2028%20days.&p=BOOKS&id=598986_niceng237er2f4.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK598986/bin/niceng237er2f4.jpg" alt="Figure 4. CRP POCT vs usual care - Antibiotics prescribed within 28 days." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 4</span><span class="title">CRP POCT vs usual care - Antibiotics prescribed within 28 days</span></h3></div></article><article data-type="table-wrap" id="figobniceng237er2tab2"><div id="niceng237er2.tab2" class="table"><h3><span class="label">Table 2</span><span class="title">CRP POCT vs usual care - Time to resoluon of symptoms/me to full recovery</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK598986/table/niceng237er2.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng237er2.tab2_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng237er2.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng237er2.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcome</th><th id="hd_h_niceng237er2.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CRP test</th><th id="hd_h_niceng237er2.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Usual care</th><th id="hd_h_niceng237er2.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Effect size</th></tr></thead><tbody><tr><td headers="hd_h_niceng237er2.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cals 2010<a class="bibr" href="#niceng237er2.ref28" rid="niceng237er2.ref28"><sup>28</sup></a></td><td headers="hd_h_niceng237er2.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Time to full recovery, days</td><td headers="hd_h_niceng237er2.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Mean</p>
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<p>LRTI 17.5 (SD 9.2)</p>
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<p>Rhinis 17.3 (SD 9.3)</p>
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</td><td headers="hd_h_niceng237er2.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Mean</p>
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<p>LRTI 19.8 (SD 9.5)</p>
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<p>Rhinis 16.6 (SD 9.9)</p>
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</td><td headers="hd_h_niceng237er2.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>-</b>
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</td></tr><tr><td headers="hd_h_niceng237er2.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Do 2016<a class="bibr" href="#niceng237er2.ref33" rid="niceng237er2.ref33"><sup>33</sup></a></td><td headers="hd_h_niceng237er2.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Time to resolution of symptoms, days</td><td headers="hd_h_niceng237er2.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Median 6 (IQR 4–10)</td><td headers="hd_h_niceng237er2.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Median 5 (IQR 4–8)</td><td headers="hd_h_niceng237er2.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">HR 0·89 (95% CI 0·77, 1·03)</td></tr><tr><td headers="hd_h_niceng237er2.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Litle 2013<a class="bibr" href="#niceng237er2.ref25" rid="niceng237er2.ref25"><sup>25</sup></a></td><td headers="hd_h_niceng237er2.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Time to resoluon of moderately bad symptoms, days</td><td headers="hd_h_niceng237er2.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Median 5 (IQR 3-8)</td><td headers="hd_h_niceng237er2.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Median 5 (IQR 3-7)</td><td headers="hd_h_niceng237er2.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Adjusted<sup>a</sup> HR 0.87 (95% CI 0.74, 1.03)</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">Abbreviations: CRP – C-reactive protein; HR – hazard ratio; IQR – interquartile range; LRTI – lower respiratory tract infection; SD – standard deviation.</p></div></dd></dl><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng237er2.tab2_1"><p class="no_margin">The adjusted model additionally controlled for age, smoking, sex, major cardiovascular or respiratory comorbidity, baseline symptoms, crepitations, wheeze, pulse > 100 beats per min, temperature > 37·8°C, respiratory rate, blood pressure, physician’s rating of severity, and duration of cough.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng237er2tab3"><div id="niceng237er2.tab3" class="table"><h3><span class="label">Table 3</span><span class="title">CRP POCT vs usual care - Number of paents substanally improved</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK598986/table/niceng237er2.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng237er2.tab3_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng237er2.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng237er2.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcome</th><th id="hd_h_niceng237er2.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CRP test n/N</th><th id="hd_h_niceng237er2.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Usual care n/N</th><th id="hd_h_niceng237er2.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Effect size</th></tr></thead><tbody><tr><td headers="hd_h_niceng237er2.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cals 2010<a class="bibr" href="#niceng237er2.ref28" rid="niceng237er2.ref28"><sup>28</sup></a></td><td headers="hd_h_niceng237er2.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Substanally improved within 7 days</td><td headers="hd_h_niceng237er2.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27/118</td><td headers="hd_h_niceng237er2.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31/125</td><td headers="hd_h_niceng237er2.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 1.03 (95% CI 0.89, 1.18)</td></tr><tr><td headers="hd_h_niceng237er2.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Melbye 1995<a class="bibr" href="#niceng237er2.ref32" rid="niceng237er2.ref32"><sup>32</sup></a></td><td headers="hd_h_niceng237er2.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Substanally improved within 7 days</td><td headers="hd_h_niceng237er2.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46/102</td><td headers="hd_h_niceng237er2.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53/128</td><td headers="hd_h_niceng237er2.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 0.94 (95% CI 0.75, 1.18)</td></tr><tr><td headers="hd_h_niceng237er2.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Melbye 1995<a class="bibr" href="#niceng237er2.ref32" rid="niceng237er2.ref32"><sup>32</sup></a></td><td headers="hd_h_niceng237er2.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Substanally improved within 28 days</td><td headers="hd_h_niceng237er2.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">71/98</td><td headers="hd_h_niceng237er2.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">82/121</td><td headers="hd_h_niceng237er2.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 0.85 (95% CI 0.57, 1.29)</td></tr><tr><td headers="hd_h_niceng237er2.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Andreeva 2014<a class="bibr" href="#niceng237er2.ref29" rid="niceng237er2.ref29"><sup>29</sup></a></td><td headers="hd_h_niceng237er2.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Fully or almost recovered within 14 days</td><td headers="hd_h_niceng237er2.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">92/101</td><td headers="hd_h_niceng237er2.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">72/78</td><td headers="hd_h_niceng237er2.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not reported</td></tr><tr><td headers="hd_h_niceng237er2.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Boere 2021<a class="bibr" href="#niceng237er2.ref27" rid="niceng237er2.ref27"><sup>27</sup></a></td><td headers="hd_h_niceng237er2.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Substanally improved within 3 weeks</td><td headers="hd_h_niceng237er2.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">86.4%<sup>a</sup></td><td headers="hd_h_niceng237er2.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">90.8%<sup>a</sup></td><td headers="hd_h_niceng237er2.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">OR 0.49 (0.21, 1.12)</td></tr><tr><td headers="hd_h_niceng237er2.tab3_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cals 2009<a class="bibr" href="#niceng237er2.ref26" rid="niceng237er2.ref26"><sup>26</sup></a></td><td headers="hd_h_niceng237er2.tab3_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Substanally improved within 28 days</td><td headers="hd_h_niceng237er2.tab3_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49/65<sup>b</sup></td><td headers="hd_h_niceng237er2.tab3_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44/59<sup>b</sup></td><td headers="hd_h_niceng237er2.tab3_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RR 0.97 (95% CI 0.53, 1.78)</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng237er2.tab3_1"><p class="no_margin">Sample size unclear.</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng237er2.tab3_2"><p class="no_margin">Modified sample size.</p></div></dd></dl><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">Abbreviations: CRP – C-reactive protein; RR – relative risk.</p></div></dd></dl></dl></div></div></div></article><article data-type="fig" id="figobniceng237er2fig5"><div id="niceng237er2.fig5" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%205.%20CRP%20POCT%20vs%20usual%20care%20-%20Mortality.&p=BOOKS&id=598986_niceng237er2f5.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK598986/bin/niceng237er2f5.jpg" alt="Figure 5. CRP POCT vs usual care - Mortality." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 5</span><span class="title">CRP POCT vs usual care - Mortality</span></h3></div></article><article data-type="table-wrap" id="figobniceng237er2tab4"><div id="niceng237er2.tab4" class="table"><h3><span class="label">Table 4</span><span class="title">Characteriscs of included studies for procalcitonin tests</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK598986/table/niceng237er2.tab4/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng237er2.tab4_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng237er2.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study Details</th><th id="hd_h_niceng237er2.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Participants</th><th id="hd_h_niceng237er2.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interventions</th><th id="hd_h_niceng237er2.tab4_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes and Results</th><th id="hd_h_niceng237er2.tab4_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments<sup>a</sup></th></tr></thead><tbody><tr><th headers="hd_h_niceng237er2.tab4_1_1_1_1 hd_h_niceng237er2.tab4_1_1_1_2 hd_h_niceng237er2.tab4_1_1_1_3 hd_h_niceng237er2.tab4_1_1_1_4 hd_h_niceng237er2.tab4_1_1_1_5" id="hd_b_niceng237er2.tab4_1_1_1_1" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">BRAHMS PCT Procalcitonin</th></tr><tr><td headers="hd_h_niceng237er2.tab4_1_1_1_1 hd_b_niceng237er2.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Lhopitallier 2021<a class="bibr" href="#niceng237er2.ref38" rid="niceng237er2.ref38"><sup>38</sup></a></p>
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<p>Switzerland</p>
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<p>Open-label cluster-RCT</p>
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<p>September 2018 to March 2020</p>
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<p><b>Follow-up:</b> 28 days</p>
|
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</td><td headers="hd_h_niceng237er2.tab4_1_1_1_2 hd_b_niceng237er2.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>469 patients</p>
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<p>Procalcitonin 195, usual care 122</p>
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<p>Lower RTI/acute cough</p>
|
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</td><td headers="hd_h_niceng237er2.tab4_1_1_1_3 hd_b_niceng237er2.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p><b>Interventions</b>: POC procalcitonin</p>
|
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<p><b>Comparator</b>: usual care</p>
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</td><td headers="hd_h_niceng237er2.tab4_1_1_1_4 hd_b_niceng237er2.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Antibiotics prescribed at index consultation</div></li><li class="half_rhythm"><div>Antibiotics prescribed within 7 days</div></li><li class="half_rhythm"><div>Antibiotics prescribed within 28 days</div></li><li class="half_rhythm"><div>Number of re-consultations within 28 days</div></li><li class="half_rhythm"><div>Hospital admissions within 7 days</div></li><li class="half_rhythm"><div>Mortality within 28 days</div></li><li class="half_rhythm"><div>Duration of symptoms by day 28</div></li></ul>
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</td><td headers="hd_h_niceng237er2.tab4_1_1_1_5 hd_b_niceng237er2.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Funding: Non-commercial. POC test kits were provided by the manufacturer</p>
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<p>Overall risk of bias: High</p>
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</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng237er2.tab4_1"><p class="no_margin">Overall risk of bias: see <a href="#niceng237er2.app9">Appendix 9</a> for details.</p></div></dd></dl><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">Abbreviations: POC – point-of-care; RCT – randomised controlled trial; RTI – respiratory tract infection.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng237er2tab5"><div id="niceng237er2.tab5" class="table"><h3><span class="label">Table 5</span><span class="title">Characteriscs of included studies for Group A Streptococcus tests</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK598986/table/niceng237er2.tab5/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng237er2.tab5_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng237er2.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study Details</th><th id="hd_h_niceng237er2.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Participants</th><th id="hd_h_niceng237er2.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interventions</th><th id="hd_h_niceng237er2.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes and Results</th><th id="hd_h_niceng237er2.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments<sup>a</sup></th></tr></thead><tbody><tr><th headers="hd_h_niceng237er2.tab5_1_1_1_1 hd_h_niceng237er2.tab5_1_1_1_2 hd_h_niceng237er2.tab5_1_1_1_3 hd_h_niceng237er2.tab5_1_1_1_4 hd_h_niceng237er2.tab5_1_1_1_5" id="hd_b_niceng237er2.tab5_1_1_1_1" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">RADT OSOM<sup>®</sup> Strep A</th></tr><tr><td headers="hd_h_niceng237er2.tab5_1_1_1_1 hd_b_niceng237er2.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Llor 2011<a class="bibr" href="#niceng237er2.ref39" rid="niceng237er2.ref39"><sup>39</sup></a></p>
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<p>Spain</p>
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<p>Open-label cluster-RCT</p>
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<p>January to May 2008</p>
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<p><b>Follow-up:</b> NR</p>
|
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</td><td headers="hd_h_niceng237er2.tab5_1_1_1_2 hd_b_niceng237er2.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>557 patients</p>
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<p>RADT 285, usual care 272</p>
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<p>Acute pharyngitis</p>
|
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</td><td headers="hd_h_niceng237er2.tab5_1_1_1_3 hd_b_niceng237er2.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p><b>Interventions</b>: RADT OSOM<sup>®</sup> Strep A test</p>
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<p><b>Comparator</b>: usual care</p>
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</td><td headers="hd_h_niceng237er2.tab5_1_1_1_4 hd_b_niceng237er2.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul><li class="half_rhythm"><div>Antibiotics prescribed at index consultation</div></li></ul>
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|
</td><td headers="hd_h_niceng237er2.tab5_1_1_1_5 hd_b_niceng237er2.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Funding: Noncommercial</p>
|
|
<p>Includes patients aged ≥14 years, slight difference to current review criteria.</p>
|
|
<p>Overall risk of bias: High</p>
|
|
</td></tr><tr><th headers="hd_h_niceng237er2.tab5_1_1_1_1 hd_h_niceng237er2.tab5_1_1_1_2 hd_h_niceng237er2.tab5_1_1_1_3 hd_h_niceng237er2.tab5_1_1_1_4 hd_h_niceng237er2.tab5_1_1_1_5" id="hd_b_niceng237er2.tab5_1_1_3_1" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">RADT Clearview<sup>®</sup> Exact Strep A</th></tr><tr><td headers="hd_h_niceng237er2.tab5_1_1_1_1 hd_b_niceng237er2.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Worrall 2007<a class="bibr" href="#niceng237er2.ref40" rid="niceng237er2.ref40"><sup>40</sup></a></p>
|
|
<p>Canada</p>
|
|
<p>Open-label cluster-RCT</p>
|
|
<p>February to April 2005</p>
|
|
<p><b>Follow-up:</b> NR</p>
|
|
</td><td headers="hd_h_niceng237er2.tab5_1_1_1_2 hd_b_niceng237er2.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>533 patients</p>
|
|
<p>RADT 120, usual care 141</p>
|
|
<p>Acute sore throat as primary symptom</p>
|
|
</td><td headers="hd_h_niceng237er2.tab5_1_1_1_3 hd_b_niceng237er2.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Interventions</b>: RADT Clearview<sup>®</sup> Exact Strep A dipstick</p>
|
|
<p><b>Comparator</b>: usual care</p>
|
|
</td><td headers="hd_h_niceng237er2.tab5_1_1_1_4 hd_b_niceng237er2.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul><li class="half_rhythm"><div>Antibiotics prescribed at index consultation</div></li></ul>
|
|
</td><td headers="hd_h_niceng237er2.tab5_1_1_1_5 hd_b_niceng237er2.tab5_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Funding: Not reported</p>
|
|
<p>Overall risk of bias: High</p>
|
|
</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng237er2.tab5_1"><p class="no_margin">Overall risk of bias: see <a href="#niceng237er2.app9">Appendix 9</a> for details.</p></div></dd></dl><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">Abbreviations: NR – not reported; POC – point of care; RADT – rapid antigen detection test; RCT – randomised controlled trial.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng237er2tab6"><div id="niceng237er2.tab6" class="table"><h3><span class="label">Table 6</span><span class="title">Rapid angen detecon test versus usual care - Anbioc prescripons at index consultaon</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK598986/table/niceng237er2.tab6/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng237er2.tab6_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng237er2.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_niceng237er2.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RADT test n/N</th><th id="hd_h_niceng237er2.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Usual care n/N</th><th id="hd_h_niceng237er2.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">P-value</th></tr></thead><tbody><tr><td headers="hd_h_niceng237er2.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Llor 2011<a class="bibr" href="#niceng237er2.ref39" rid="niceng237er2.ref39"><sup>39</sup></a></td><td headers="hd_h_niceng237er2.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">123/281</td><td headers="hd_h_niceng237er2.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">168/262</td><td headers="hd_h_niceng237er2.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><0.001</td></tr><tr><td headers="hd_h_niceng237er2.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Worrall 2007<a class="bibr" href="#niceng237er2.ref40" rid="niceng237er2.ref40"><sup>40</sup></a></td><td headers="hd_h_niceng237er2.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32/120</td><td headers="hd_h_niceng237er2.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">82/141</td><td headers="hd_h_niceng237er2.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><0.001</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">Abbreviations: RADT – rapid antigen detection test</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng237er2tab7"><div id="niceng237er2.tab7" class="table"><h3><span class="label">Table 7</span><span class="title">Characteriscs of included study for Influenza tests</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK598986/table/niceng237er2.tab7/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng237er2.tab7_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng237er2.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study Details</th><th id="hd_h_niceng237er2.tab7_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Participants</th><th id="hd_h_niceng237er2.tab7_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interventions</th><th id="hd_h_niceng237er2.tab7_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes and Results</th><th id="hd_h_niceng237er2.tab7_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comments<sup>a</sup></th></tr></thead><tbody><tr><th headers="hd_h_niceng237er2.tab7_1_1_1_1 hd_h_niceng237er2.tab7_1_1_1_2 hd_h_niceng237er2.tab7_1_1_1_3 hd_h_niceng237er2.tab7_1_1_1_4 hd_h_niceng237er2.tab7_1_1_1_5" id="hd_b_niceng237er2.tab7_1_1_1_1" colspan="5" rowspan="1" style="text-align:left;vertical-align:top;">BD Directigen<sup>TM</sup> Flu A + B rapid test <i>(Not currently available in the UK)</i></th></tr><tr><td headers="hd_h_niceng237er2.tab7_1_1_1_1 hd_b_niceng237er2.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Berthod 2015<a class="bibr" href="#niceng237er2.ref41" rid="niceng237er2.ref41"><sup>41</sup></a> <a href="https://clinicaltrials.gov/show/NCT00821626" title="Study NCT00821626" ref="pagearea=body&targetsite=external&targetcat=link&targettype=clinical-trial">NCT00821626</a><a class="bibr" href="#niceng237er2.ref42" rid="niceng237er2.ref42"><sup>42</sup></a></p>
|
|
<p>Switzerland</p>
|
|
<p>Open-label RCT</p>
|
|
<p>December 2008 to November 2012</p>
|
|
<p><b>Follow-up:</b> NR</p>
|
|
</td><td headers="hd_h_niceng237er2.tab7_1_1_1_2 hd_b_niceng237er2.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>93 patients RADT 60, usual care 33</p>
|
|
<p>Fever or cough or sore throat within 4 days; illness within 14 days of a trip abroad</p>
|
|
</td><td headers="hd_h_niceng237er2.tab7_1_1_1_3 hd_b_niceng237er2.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p><b>Interventions</b>: BD Directigen A + B</p>
|
|
<p><b>Comparator</b>: usual care</p>
|
|
</td><td headers="hd_h_niceng237er2.tab7_1_1_1_4 hd_b_niceng237er2.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<ul><li class="half_rhythm"><div>Antibiotics prescribed at index consultation</div></li><li class="half_rhythm"><div>Mortality</div></li></ul>
|
|
</td><td headers="hd_h_niceng237er2.tab7_1_1_1_5 hd_b_niceng237er2.tab7_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Funding: Not reported</p>
|
|
<p>Trial finished early due to low sensitivity of the intervention.</p>
|
|
<p>Overall risk of bias: High</p>
|
|
</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng237er2.tab7_1"><p class="no_margin">Overall risk of bias: see <a href="#niceng237er2.app9">Appendix 9</a> for details.</p></div></dd></dl><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">Abbreviations: NR – not reported; RADT – rapid antigen detection test; RCT – randomised controlled trial.</p></div></dd></dl></dl></div></div></div></article><article data-type="fig" id="figobniceng237er2fig6"><div id="niceng237er2.fig6" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%206.%20PRISMA%20flowchart%20for%20the%20selection%20of%20systematic%20reviews%20and%20cost%20utility%20studies.&p=BOOKS&id=598986_niceng237er2f6.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK598986/bin/niceng237er2f6.jpg" alt="Figure 6. PRISMA flowchart for the selection of systematic reviews and cost utility studies." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 6</span><span class="title">PRISMA flowchart for the selection of systematic reviews and cost utility studies</span></h3></div></article><article data-type="table-wrap" id="figobniceng237er2tab8"><div id="niceng237er2.tab8" class="table"><h3><span class="label">Table 8</span><span class="title">Characteriscs of included cost ulity studies</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK598986/table/niceng237er2.tab8/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng237er2.tab8_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng237er2.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Author, Year</th><th id="hd_h_niceng237er2.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Patient Characteristics, Setting</th><th id="hd_h_niceng237er2.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Perspective, Time Horizon, Country</th><th id="hd_h_niceng237er2.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Index Testing Strategy</th><th id="hd_h_niceng237er2.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Comparator Testing Strategy(s)</th><th id="hd_h_niceng237er2.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Target Condition</th><th id="hd_h_niceng237er2.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Analytic Approach</th></tr></thead><tbody><tr><td headers="hd_h_niceng237er2.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Billir, 2021<a class="bibr" href="#niceng237er2.ref45" rid="niceng237er2.ref45"><sup>45</sup></a></td><td headers="hd_h_niceng237er2.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Age reflects US population distribution (mean age 38, 22.4%<18); patients presenting with pharyngitis with sore throat who are tested for GAS.</p>
|
|
<p>Not stated; assume primary care.</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>US payer.</p>
|
|
<p>1 year.</p>
|
|
<p>USA.</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">POC nucleic acid amplification tests (POC NAAT)</td><td headers="hd_h_niceng237er2.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">RADTs + culture confirmation of negative results (current standard of care)</td><td headers="hd_h_niceng237er2.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">GAS</td><td headers="hd_h_niceng237er2.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Model-based</td></tr><tr><td headers="hd_h_niceng237er2.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Chew, 2022<a class="bibr" href="#niceng237er2.ref46" rid="niceng237er2.ref46"><sup>46</sup></a></td><td headers="hd_h_niceng237er2.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Patients (any age): systemic antibiotic prescription; ICD 10 code for infection; fever as the chief complaint; documented temperature >37.5C. Patients with chronic respiratory infections or bronchitis of unknown acuity were excluded.</p>
|
|
<p>Government funded primary care units in Mueang Chiang Rai.</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Health system.</p>
|
|
<p>1 year.</p>
|
|
<p>Thailand</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Pulse oximetry-aided ARI management</td><td headers="hd_h_niceng237er2.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Standard of care (no pulse oximetry device)</td><td headers="hd_h_niceng237er2.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">ARI</td><td headers="hd_h_niceng237er2.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Model-based; population data from retrospective review</td></tr><tr><td headers="hd_h_niceng237er2.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Francis, 2020<a class="bibr" href="#niceng237er2.ref34" rid="niceng237er2.ref34"><sup>34</sup></a></td><td headers="hd_h_niceng237er2.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Patients aged ≥40y; has exacerbation that has lasted at least 34 hours and no longer than 21 days; COPD diagnosis in clinical record/on COPD practice register.</p>
|
|
<p>Primary care.</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>UK NHS perspective.</p>
|
|
<p>6 months.</p>
|
|
<p>Wales and England.</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Alere Afinion CRP POCT</td><td headers="hd_h_niceng237er2.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">No test (current standard of care)</td><td headers="hd_h_niceng237er2.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Bacterial COPD Exacerbation</td><td headers="hd_h_niceng237er2.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">RCT</td></tr><tr><td headers="hd_h_niceng237er2.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Fraser, 2020<a class="bibr" href="#niceng237er2.ref47" rid="niceng237er2.ref47"><sup>47</sup></a></td><td headers="hd_h_niceng237er2.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Adults and children who present with an acute sore throat.</p>
|
|
<p>Primary and secondary care (urgent care/walk-in centres and emergency departments, modelled separately).</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>UK NHS and Personal Social Services.</p>
|
|
<p>1 year.</p>
|
|
<p>UK.</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">POCT (14 tests evaluated) in conjunction with clinical scoring tools e.g. Centor and FeverPAIN score for strep A.</td><td headers="hd_h_niceng237er2.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Current standard of care: clinical assessment incorporating clinical scoring tools (no POCT).</td><td headers="hd_h_niceng237er2.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">GAS</td><td headers="hd_h_niceng237er2.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Model-based</td></tr><tr><td headers="hd_h_niceng237er2.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Holmes, 2018<a class="bibr" href="#niceng237er2.ref48" rid="niceng237er2.ref48"><sup>48</sup></a></td><td headers="hd_h_niceng237er2.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Adult patients; symptoms of ARI for >12 hours.</p>
|
|
<p>Primary care</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>UK NHS perspective.</p>
|
|
<p>28 days.</p>
|
|
<p>UK</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Alere Afinion AS100 CRP POCT</td><td headers="hd_h_niceng237er2.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Current standard of care (no POCT)</td><td headers="hd_h_niceng237er2.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">ARI</td><td headers="hd_h_niceng237er2.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Model-based</td></tr><tr><td headers="hd_h_niceng237er2.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Hunter, 2015<a class="bibr" href="#niceng237er2.ref49" rid="niceng237er2.ref49"><sup>49</sup></a></td><td headers="hd_h_niceng237er2.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Adult patients; attend primary care with RTI symptoms.</p>
|
|
<p>Primary care</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>UK NHS perspective.</p>
|
|
<p>3 years.</p>
|
|
<p>UK.</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Afinion Analyzer CRP POCT by GP; CRP POCT by nurse; CRP POCT by GP + communication training for GP</td><td headers="hd_h_niceng237er2.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Current standard of care (no test)</td><td headers="hd_h_niceng237er2.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">RTI</td><td headers="hd_h_niceng237er2.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Model-based</td></tr><tr><td headers="hd_h_niceng237er2.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Little, 2014<a class="bibr" href="#niceng237er2.ref50" rid="niceng237er2.ref50"><sup>50</sup></a></td><td headers="hd_h_niceng237er2.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Patients aged ≥3y; acute sore throat.</p>
|
|
<p>Primary care</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>UK NHS perspective.</p>
|
|
<p>28 days.</p>
|
|
<p>UK.</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Clinical scoring algorithm (FeverPAIN) +RADT if score high on algorithm</td><td headers="hd_h_niceng237er2.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Clinical scoring algorithm alone (FeverPAIN) and a separate control (delayed prescribing)</td><td headers="hd_h_niceng237er2.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Lancefield group A/C/G streptococci</td><td headers="hd_h_niceng237er2.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">RCT</td></tr><tr><td headers="hd_h_niceng237er2.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Mac, 2020<a class="bibr" href="#niceng237er2.ref51" rid="niceng237er2.ref51"><sup>51</sup></a></td><td headers="hd_h_niceng237er2.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Patients aged 65; signs of symptoms suggestive of influenza.</p>
|
|
<p>Emergency Department.</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Single healthcare payer.</p>
|
|
<p>Lifetime.</p>
|
|
<p>Canada</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">RIDTs; digital immunoassays (DIA); rapid NAAT</td><td headers="hd_h_niceng237er2.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">1) Do not treat 2) treat everyone 3) clinical judgement 4) batch PCR test, treat until results available 5) batch PCR test, do not treat until results available</td><td headers="hd_h_niceng237er2.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Influenza-like illness</td><td headers="hd_h_niceng237er2.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Model-based</td></tr><tr><td headers="hd_h_niceng237er2.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Michaelidis, 2014<a class="bibr" href="#niceng237er2.ref52" rid="niceng237er2.ref52"><sup>52</sup></a></td><td headers="hd_h_niceng237er2.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>1. Adults; ARTI judged by their doctor to require antibiotics. 2. Adults; ARTI prior to any decision about antibiotics.</p>
|
|
<p>Outpatient clinic.</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Healthcare system. ARTI treatment episode.</p>
|
|
<p>US.</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">POC procalcitonin-guided antibiotic therapy.</td><td headers="hd_h_niceng237er2.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Usual care (no POC procalcitonin).</td><td headers="hd_h_niceng237er2.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">ARIs</td><td headers="hd_h_niceng237er2.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Model-based using two real trial cohorts</td></tr><tr><td headers="hd_h_niceng237er2.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Nicholson, 2014<a class="bibr" href="#niceng237er2.ref54" rid="niceng237er2.ref54"><sup>54</sup></a></td><td headers="hd_h_niceng237er2.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Patients aged >65y or >18y with underlying chronic heart or lung disease; has an acute exacerbation of chronic cardio-pulmonary illness or influenza-like illness of <7 days.</p>
|
|
<p>Hospital setting (presenting at medical admissions units, or any ward accepting acute medic admissions).</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>UK NHS perspective.</p>
|
|
<p>28 days.</p>
|
|
<p>UK.</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">POC tests (Quidel for influenza, and BinaxNOW for the pneumococcal antigen)</td><td headers="hd_h_niceng237er2.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<ol><li class="half_rhythm"><div>Laboratory-based PCRs (for influenza A and B and RSV A and B), plus laboratory pneumococcal antigen testing</div></li><li class="half_rhythm"><div>Conventional laboratory diagnostic assessment (culture/serology)</div></li></ol>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Influenza A and B, respiratory syncytial virus and pneumococcal infection</td><td headers="hd_h_niceng237er2.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">RCT</td></tr><tr><td headers="hd_h_niceng237er2.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Oppong, 2013<a class="bibr" href="#niceng237er2.ref55" rid="niceng237er2.ref55"><sup>55</sup></a></td><td headers="hd_h_niceng237er2.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Patients aged ≥18 years; presenting to GP with acute or worsened cough as the main symptom for up to 28 days, or who had a clinical presentation suggesting LRTI.</p>
|
|
<p>Primary care.</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Health service perspective.</p>
|
|
<p>28 days.</p>
|
|
<p>Sweden and Norway.</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">CRP POCT</td><td headers="hd_h_niceng237er2.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">No POCT CRP available</td><td headers="hd_h_niceng237er2.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Community-acquired LRTI</td><td headers="hd_h_niceng237er2.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Data from observational study.</td></tr><tr><td headers="hd_h_niceng237er2.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Rothberg, 2003a<a class="bibr" href="#niceng237er2.ref57" rid="niceng237er2.ref57"><sup>57</sup></a></td><td headers="hd_h_niceng237er2.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Unvaccinated, healthy, working adults between 20 and 50 years of age presenting with influenza-like illness during the influenza season.</p>
|
|
<p>Not stated; assume primary care.</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Societal.</p>
|
|
<p>Unclear.</p>
|
|
<p>US</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Rapid antigen tests (Directigen A/B; Flu OIA; QuickVue; ZstatFlu); followed by different antiviral therapies</td><td headers="hd_h_niceng237er2.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">No test followed by different antiviral therapies</td><td headers="hd_h_niceng237er2.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Influenza A and B</td><td headers="hd_h_niceng237er2.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Model-based</td></tr><tr><td headers="hd_h_niceng237er2.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Rothberg, 2003b<a class="bibr" href="#niceng237er2.ref56" rid="niceng237er2.ref56"><sup>56</sup></a></td><td headers="hd_h_niceng237er2.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Non-institutionalised patients aged >65y; influenza-like illness; separate analyses for vaccinated vs unvaccinated.</p>
|
|
<p>Primary care.</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Societal.</p>
|
|
<p>Unclear.</p>
|
|
<p>US</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Rapid antigen test QuickVue; followed by different antiviral therapies</td><td headers="hd_h_niceng237er2.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">No test followed by different antiviral therapies (including no therapy)</td><td headers="hd_h_niceng237er2.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Influenza A and B</td><td headers="hd_h_niceng237er2.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Model-based</td></tr><tr><td headers="hd_h_niceng237er2.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Smith, 2002<a class="bibr" href="#niceng237er2.ref58" rid="niceng237er2.ref58"><sup>58</sup></a></td><td headers="hd_h_niceng237er2.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Patients aged 32y; influenza-like symptoms and a fever ≥37.8c; different ages included in sensitivity analyses.</p>
|
|
<p>Not explicitly stated; assume primary care.</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Societal.</p>
|
|
<p>Unclear.</p>
|
|
<p>US</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Rapid test; followed by different antiviral therapies</td><td headers="hd_h_niceng237er2.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">No test followed by different antiviral therapies (including no therapy)</td><td headers="hd_h_niceng237er2.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Influenza A and B</td><td headers="hd_h_niceng237er2.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Model-based</td></tr><tr><td headers="hd_h_niceng237er2.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">You, 2017<a class="bibr" href="#niceng237er2.ref59" rid="niceng237er2.ref59"><sup>59</sup></a></td><td headers="hd_h_niceng237er2.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Elderly patients (65-90); influenza-like symptoms. Patients with symptoms > 7 days or previously treated were excluded.</p>
|
|
<p>Ambulatory setting (outpatient).</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Health service perspective.</p>
|
|
<p>Not stated.</p>
|
|
<p>Hong Kong</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Rapid molecular PCR to inform antiviral therapy</td><td headers="hd_h_niceng237er2.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">No test; clinical judgement</td><td headers="hd_h_niceng237er2.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Influenza A and B</td><td headers="hd_h_niceng237er2.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Model-based</td></tr><tr><td headers="hd_h_niceng237er2.tab8_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Neuner, 2003<a class="bibr" href="#niceng237er2.ref53" rid="niceng237er2.ref53"><sup>53</sup></a></td><td headers="hd_h_niceng237er2.tab8_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Adults with suspected GAS pharyngitis, within 3 days of symptom onset, patients without a history of acute rheumatic fever or glomerulonephritis, patients with a history of penicillin allergy also not included.</p>
|
|
<p>Not explicitly stated; assume primary care.</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Societal.</p>
|
|
<p>1 year.</p>
|
|
<p>US.</p>
|
|
</td><td headers="hd_h_niceng237er2.tab8_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Optical immunoassay (OIA)</td><td headers="hd_h_niceng237er2.tab8_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">1) Observation only 2) Antibiotics for all 3) Throat culture +antibiotics for positives 4) OIA followed by culture to confirm negative results, antibiotic treatment for positive cases</td><td headers="hd_h_niceng237er2.tab8_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">GAS</td><td headers="hd_h_niceng237er2.tab8_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Model-based</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">CRP: C-reacve protein; GAS: Group A streptococcus; GP: general pracce; LRTI: lower respiratory tract infecon; OIA: opcal immunoassay; POC: point of care; POCT: point of care test US: United States</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng237er2tab9"><div id="niceng237er2.tab9" class="table"><h3><span class="label">Table 9</span><span class="title">Data extracon for cost-ulity studies - results</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK598986/table/niceng237er2.tab9/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng237er2.tab9_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_niceng237er2.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Author, Year</th><th id="hd_h_niceng237er2.tab9_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Index Testing Strategy</th><th id="hd_h_niceng237er2.tab9_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Target Condition</th><th id="hd_h_niceng237er2.tab9_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Key Costs Results</th><th id="hd_h_niceng237er2.tab9_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Key Effectiveness Results</th><th id="hd_h_niceng237er2.tab9_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">ICER Results</th><th id="hd_h_niceng237er2.tab9_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Headline Results of Uncertainty Analyses</th><th id="hd_h_niceng237er2.tab9_1_1_1_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Key Conclusions</th></tr></thead><tbody><tr><th headers="hd_h_niceng237er2.tab9_1_1_1_1 hd_h_niceng237er2.tab9_1_1_1_2 hd_h_niceng237er2.tab9_1_1_1_3 hd_h_niceng237er2.tab9_1_1_1_4 hd_h_niceng237er2.tab9_1_1_1_5 hd_h_niceng237er2.tab9_1_1_1_6 hd_h_niceng237er2.tab9_1_1_1_7 hd_h_niceng237er2.tab9_1_1_1_8" id="hd_b_niceng237er2.tab9_1_1_1_1" colspan="8" rowspan="1" style="text-align:left;vertical-align:middle;">C-Reactive Protein tests (ARI) *Note, see <a class="bibr" href="#niceng237er2.ref34" rid="niceng237er2.ref34">Francis et al. (2020)</a> below who also focused on POC CRP but specifically for COPD exacerbation</th></tr><tr><td headers="hd_h_niceng237er2.tab9_1_1_1_1 hd_b_niceng237er2.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Holmes, 2018<a class="bibr" href="#niceng237er2.ref48" rid="niceng237er2.ref48"><sup>48</sup></a></td><td headers="hd_h_niceng237er2.tab9_1_1_1_2 hd_b_niceng237er2.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Alere Afinion AS100 CRP POCT</td><td headers="hd_h_niceng237er2.tab9_1_1_1_3 hd_b_niceng237er2.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">ARI</td><td headers="hd_h_niceng237er2.tab9_1_1_1_4 hd_b_niceng237er2.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Costs per patient</p>
|
|
<p>Pragmatic use of testing: Test £52.35</p>
|
|
<p>No test £40.41</p>
|
|
<p>Adhering to guidelines: Test £48.79</p>
|
|
<p>No test £39.48</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_5 hd_b_niceng237er2.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>QALYs per patient</p>
|
|
<p>Pragmatic use of testing: Test 0.0615</p>
|
|
<p>No test 0.0609</p>
|
|
<p>Adhering to guidelines: Test 0.0577</p>
|
|
<p>No test 0.0556</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_6 hd_b_niceng237er2.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Pragmatic use of testing: £19,705</p>
|
|
<p>Adhering to guidelines: £4,390</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_7 hd_b_niceng237er2.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
|
|
<p><i>Pragmatic use of testing</i> The probability that test is cost-effective at £20,000 per QALY threshold is 49.06%, and 62.82% at £30,000 per QALY threshold.</p>
|
|
<p><i>Adhering to guidelines</i> Probability test is cost-effective at £20,000/QALY threshold is 84.10%, and 86.33% at £30,000.</p>
|
|
<p>If the test cost 18p more, or test use fell by 5%, the ICER exceeds £20,000. Test results in higher utility but at a higher cost in 75% of simulations.</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_8 hd_b_niceng237er2.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">POC CRP is borderline cost-effective. Closer adherence to the NICE CRP recommendation (by restricting testing to adults with symptoms of LRTI and prescribing appropriate courses of antibiotics) results in a more favourable ICER. The test must cost below £9.67 to be costeffective. Including the cost of antimicrobial resistance improves the cost-effectiveness of the test.</td></tr><tr><td headers="hd_h_niceng237er2.tab9_1_1_1_1 hd_b_niceng237er2.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Hunter, 2015<a class="bibr" href="#niceng237er2.ref49" rid="niceng237er2.ref49"><sup>49</sup></a></td><td headers="hd_h_niceng237er2.tab9_1_1_1_2 hd_b_niceng237er2.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Afinion Analyzer CRP POCT by GP; CRP POCT by nurse; CRP POCT by GP+ communication training for GP</td><td headers="hd_h_niceng237er2.tab9_1_1_1_3 hd_b_niceng237er2.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">RTI</td><td headers="hd_h_niceng237er2.tab9_1_1_1_4 hd_b_niceng237er2.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Cost per 100 patients</p>
|
|
<p>GP+CRP: £18,039</p>
|
|
<p>Nurse+CRP: £17,401</p>
|
|
<p>GP+CRP+training: £18,431</p>
|
|
<p>No test: £18,081</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_5 hd_b_niceng237er2.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>QALYs per 100 patients</p>
|
|
<p>GP+CRP: 255.764</p>
|
|
<p>Nurse+CRP: 255.761</p>
|
|
<p>GP+CRP+training: 255.588</p>
|
|
<p>No test: 255.630</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_6 hd_b_niceng237er2.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">GP+CRP and nurse+CRP are dominant over current practice.</td><td headers="hd_h_niceng237er2.tab9_1_1_1_7 hd_b_niceng237er2.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">GP+CRP is dominant compared to current practice in 50% of simulations, in 65% the nurse+CRP is dominant and in 19% the GP+CRP+training is dominant. Nurse+CRP has the highest NMB in CEAC. Changing most model parameters has little impact on conclusions.</td><td headers="hd_h_niceng237er2.tab9_1_1_1_8 hd_b_niceng237er2.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">GP+CRP and nurse+CRP are dominant over current practice. The GP plus CRP testing and communication training strategy is associated with increased costs and reduced QALYs These strategies are associated with reduced risks of infection and rates of antibiotic prescribing.</td></tr><tr><td headers="hd_h_niceng237er2.tab9_1_1_1_1 hd_b_niceng237er2.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Oppong, 2013<a class="bibr" href="#niceng237er2.ref55" rid="niceng237er2.ref55"><sup>55</sup></a></td><td headers="hd_h_niceng237er2.tab9_1_1_1_2 hd_b_niceng237er2.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">CRP POCT</td><td headers="hd_h_niceng237er2.tab9_1_1_1_3 hd_b_niceng237er2.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Community-acquired LRTI</td><td headers="hd_h_niceng237er2.tab9_1_1_1_4 hd_b_niceng237er2.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Test increases healthcare costs by €11.27 per patient</td><td headers="hd_h_niceng237er2.tab9_1_1_1_5 hd_b_niceng237er2.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">QALY gain of 0.0012 with test per patient</td><td headers="hd_h_niceng237er2.tab9_1_1_1_6 hd_b_niceng237er2.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">€ 9,391</td><td headers="hd_h_niceng237er2.tab9_1_1_1_7 hd_b_niceng237er2.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">At a WTP threshold of €30,000, the probability of POC CRP being cost-effective is approximately 70%.</td><td headers="hd_h_niceng237er2.tab9_1_1_1_8 hd_b_niceng237er2.tab9_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Results provide evidence of cost-effectiveness of testing in terms of cost per QALY and cost per unit reduction in antibiotic prescribing. There are however resource implications from widespread use of the test.</td></tr><tr><th headers="hd_h_niceng237er2.tab9_1_1_1_1 hd_h_niceng237er2.tab9_1_1_1_2 hd_h_niceng237er2.tab9_1_1_1_3 hd_h_niceng237er2.tab9_1_1_1_4 hd_h_niceng237er2.tab9_1_1_1_5 hd_h_niceng237er2.tab9_1_1_1_6 hd_h_niceng237er2.tab9_1_1_1_7 hd_h_niceng237er2.tab9_1_1_1_8" id="hd_b_niceng237er2.tab9_1_1_5_1" colspan="8" rowspan="1" style="text-align:left;vertical-align:middle;">Tests for COPD exacerbation</th></tr><tr><td headers="hd_h_niceng237er2.tab9_1_1_1_1 hd_b_niceng237er2.tab9_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Francis, 2020<a class="bibr" href="#niceng237er2.ref34" rid="niceng237er2.ref34"><sup>34</sup></a></td><td headers="hd_h_niceng237er2.tab9_1_1_1_2 hd_b_niceng237er2.tab9_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Alere Afinion CRP POCT</td><td headers="hd_h_niceng237er2.tab9_1_1_1_3 hd_b_niceng237er2.tab9_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Bacterial exacerbation of COPD</td><td headers="hd_h_niceng237er2.tab9_1_1_1_4 hd_b_niceng237er2.tab9_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Costs per patient:</p>
|
|
<p>Test: £759.35</p>
|
|
<p>No test: £629.72</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_5 hd_b_niceng237er2.tab9_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>QALYs per patient:</p>
|
|
<p>Test: 0.3</p>
|
|
<p>No test: 0.2915</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_6 hd_b_niceng237er2.tab9_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">£15,251</td><td headers="hd_h_niceng237er2.tab9_1_1_1_7 hd_b_niceng237er2.tab9_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Results remained reasonably robust when cost inputs were changed but were sensitive to changes in QALY inputs. The ICER would reduce to £1,054 if COPD-related costs only were included. Most results found CRP POCT to be more costly but more effective. The CUA (using imputation and an ITT approach) gave an ICER of £14,334.</td><td headers="hd_h_niceng237er2.tab9_1_1_1_8 hd_b_niceng237er2.tab9_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">The use of CRP POCT in primary care reduces both antibiotic consumption and costs, without significantly affecting other COPD medication costs, healthcare resource use and HRQoL.</td></tr><tr><th headers="hd_h_niceng237er2.tab9_1_1_1_1 hd_h_niceng237er2.tab9_1_1_1_2 hd_h_niceng237er2.tab9_1_1_1_3 hd_h_niceng237er2.tab9_1_1_1_4 hd_h_niceng237er2.tab9_1_1_1_5 hd_h_niceng237er2.tab9_1_1_1_6 hd_h_niceng237er2.tab9_1_1_1_7 hd_h_niceng237er2.tab9_1_1_1_8" id="hd_b_niceng237er2.tab9_1_1_7_1" colspan="8" rowspan="1" style="text-align:left;vertical-align:middle;">Group A Streptococcus tests (including Group C/G)</th></tr><tr><td headers="hd_h_niceng237er2.tab9_1_1_1_1 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Billir, 2021<a class="bibr" href="#niceng237er2.ref45" rid="niceng237er2.ref45"><sup>45</sup></a></td><td headers="hd_h_niceng237er2.tab9_1_1_1_2 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">POC NAAT</td><td headers="hd_h_niceng237er2.tab9_1_1_1_3 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Group A streptococcus (GAS) pharyngitis</td><td headers="hd_h_niceng237er2.tab9_1_1_1_4 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Costs per patient:</p>
|
|
<p>POC NAAT: $44</p>
|
|
<p>RADT+culture: $78</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_5 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>QALDs lost per patient:</p>
|
|
<p>POC NAAT 0.0413</p>
|
|
<p>RADT+culture 0.0451</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_6 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">POC NAAT dominant</td><td headers="hd_h_niceng237er2.tab9_1_1_1_7 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Model results relatively insensitive to 20% variation across parameters. The most sensitive were test sensitivity and specificity. The different scenario analyses (including a GAS outbreak) also showed results robust.</td><td headers="hd_h_niceng237er2.tab9_1_1_1_8 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Use of POC NAAT is slightly more effective than RADT+culture without incurring additional costs. POC NAAT also reduces unnecessary antibiotic use.</td></tr><tr><td headers="hd_h_niceng237er2.tab9_1_1_1_1 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Little, 2014<a class="bibr" href="#niceng237er2.ref50" rid="niceng237er2.ref50"><sup>50</sup></a></td><td headers="hd_h_niceng237er2.tab9_1_1_1_2 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Clinical scoring algorithm (FeverPAIN) +RADT if score high on algorithm</td><td headers="hd_h_niceng237er2.tab9_1_1_1_3 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Lancefield group A/C/G streptococci</td><td headers="hd_h_niceng237er2.tab9_1_1_1_4 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Costs per patient: RADT £48.50</p>
|
|
<p>Clinical algorithm: £45.90</p>
|
|
<p>Control: £49.70</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_5 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>QALYs per patient: RADT 0.018</p>
|
|
<p>Clinical algorithm: 0.017 Control 0.017</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_6 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>£74,286 (14 day)</p>
|
|
<p>£24,528 (28 day)</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_7 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">At threshold of £30,000/QALY, the probabilities of costeffectiveness are 25%, 40% and 35%, for the delayed control, clinical algorithm and RADT groups, respectively (14-day results). For the 28-day QALY gain, the same values are 28%, 38% and 35%.</td><td headers="hd_h_niceng237er2.tab9_1_1_1_8 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Differences in QALYs generated were very small with wide CIs, and therefore there were no statistically significant differences between any groups. The CEACs indicate that the clinical algorithm is the most likely to be cost-effective.</td></tr><tr><td headers="hd_h_niceng237er2.tab9_1_1_1_1 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Fraser, 2020<a class="bibr" href="#niceng237er2.ref47" rid="niceng237er2.ref47"><sup>47</sup></a></td><td headers="hd_h_niceng237er2.tab9_1_1_1_2 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">POCT (14 tests evaluated) in conjunction with clinical scoring tools e.g. Centor and FeverPAIN score for strep A</td><td headers="hd_h_niceng237er2.tab9_1_1_1_3 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Group A streptococcus (GAS)</td><td headers="hd_h_niceng237er2.tab9_1_1_1_4 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Costs per 1000 patients in primary care: NADAL Strep A–test (cheapest test): £54,394 Cobas Liat Strep A Assay (most expensive test): £71,277</p>
|
|
<p>No test: £49,147</p>
|
|
<p>Costs per 1000 patients in secondary care: NADAL Strep A–test (cheapest test): £49,318 Cobas Liat Strep A Assay (most expensive): £65,186</p>
|
|
<p>No test £49,147</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_5 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>QALYs per 1000 patients in primary care: Abbott Clearview Exact Strep A cassette or test strip (lowest QALYs): 859.821 Cepheid’s Xpert Xpress Strep A test (highest QALYs): 895.829 No test: 859.825</p>
|
|
<p>QALYs per 1000 patients in secondary care: Abbott Clearview tests generated fewer QALYs than usual care; remaining tests all generated more QALYs than usual care</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_6 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Usual care dominant over Abbott Clearview Exact Strep A cassette or test strip; ICERs for remaining tests suggest testing is more costly but more effective than usual care (primary and secondary care)</td><td headers="hd_h_niceng237er2.tab9_1_1_1_7 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">
|
|
<p>
|
|
<i>Primary care</i>
|
|
</p>
|
|
<p>Results were similar to the base-case results, with ICERs indicating that usual care dominated two (the Abbott Clearview Strep A tests) of the 14 tests. The probability for testing to be cost-effective was zero at a cost-effectiveness threshold of £20,000 per QALY in all scenarios, regardless of the test used. The base-case ICERs are highly sensitive to model assumptions and inputs.</p>
|
|
<p>
|
|
<i>Secondary care</i>
|
|
</p>
|
|
<p>Results mirrored the primary care model.</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_8 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">POCT is not cost-effective compared with usual care across all populations evaluated. Important uncertainties in the model include parameter inputs and assumptions that increase the cost of testing (acquisition cost of test, additional clinician time for administering and processing test results, cost of throat culture for those testing negative) and the penalty for antibiotic over-prescription (acquisition cost of antibiotic and probabilities for penicillin-induced anaphylaxis and rash).</td></tr><tr><td headers="hd_h_niceng237er2.tab9_1_1_1_1 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Neuner, 2003<a class="bibr" href="#niceng237er2.ref53" rid="niceng237er2.ref53"><sup>53</sup></a></td><td headers="hd_h_niceng237er2.tab9_1_1_1_2 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Optical immunoassay (OIA)</td><td headers="hd_h_niceng237er2.tab9_1_1_1_3 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Group A streptococcus (GAS) pharyngitis</td><td headers="hd_h_niceng237er2.tab9_1_1_1_4 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Costs per patient:</p>
|
|
<p>OIA test: $11.73</p>
|
|
<p>Observation: $9.84</p>
|
|
<p>Culture: $6.66</p>
|
|
<p>Empirical therapy: $12.74</p>
|
|
<p>OIA+culture: $15.15</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_5 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>QALDs lost per patient:</p>
|
|
<p>OIA test: 0.272</p>
|
|
<p>Observation: 0.275</p>
|
|
<p>Culture: 0.267</p>
|
|
<p>Empirical therapy: 0.404</p>
|
|
<p>OIA+culture: 0.272</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_6 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">OIA test dominated by culture</td><td headers="hd_h_niceng237er2.tab9_1_1_1_7 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Results unchanged by most sensitivity analyses; they generally made observation more cost-effective. If the probability of side effects is higher, observation is preferred. OIA was only more cost-effective than culture when its cost was greatly reduced. Culture remained the cheapest strategy at all ranges of OIA characteristics tested.</td><td headers="hd_h_niceng237er2.tab9_1_1_1_8 hd_b_niceng237er2.tab9_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Culture was by a slight margin the most cost-effective in the base-case analysis. Empirical treatment was less effective than the remaining strategies (including OIA), which were all similar in terms of costeffectiveness. Analyses do not support guideline recommendations for eliminating the use of culture to diagnose GAS.</td></tr><tr><th headers="hd_h_niceng237er2.tab9_1_1_1_1 hd_h_niceng237er2.tab9_1_1_1_2 hd_h_niceng237er2.tab9_1_1_1_3 hd_h_niceng237er2.tab9_1_1_1_4 hd_h_niceng237er2.tab9_1_1_1_5 hd_h_niceng237er2.tab9_1_1_1_6 hd_h_niceng237er2.tab9_1_1_1_7 hd_h_niceng237er2.tab9_1_1_1_8" id="hd_b_niceng237er2.tab9_1_1_12_1" colspan="8" rowspan="1" style="text-align:left;vertical-align:middle;">Influenza tests</th></tr><tr><td headers="hd_h_niceng237er2.tab9_1_1_1_1 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Mac, 2020<a class="bibr" href="#niceng237er2.ref51" rid="niceng237er2.ref51"><sup>51</sup></a></td><td headers="hd_h_niceng237er2.tab9_1_1_1_2 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Rapid influenza diagnosc tests (RIDTs); Digital immunoassays (DIA); rapid nucleic acid amplificaon tests (NAAT); followed by anviral therapy</td><td headers="hd_h_niceng237er2.tab9_1_1_1_3 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Influenza-like illness</td><td headers="hd_h_niceng237er2.tab9_1_1_1_4 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Costs per patient:</p>
|
|
<p>RIDT: $622.52</p>
|
|
<p>DIA: $618.99</p>
|
|
<p>NAAT: $636.75</p>
|
|
<p>No test (no treatment): $608.19</p>
|
|
<p>No test (treat everyone): $630.01;</p>
|
|
<p>Batch PCR (treat): $661.19;</p>
|
|
<p>Batch PCR (wait): $661.30</p>
|
|
<p>Clinical judgement: $611.02</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_5 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>QALYs per patient:</p>
|
|
<p>RIDT 15.0175</p>
|
|
<p>DIA 15.0338</p>
|
|
<p>NAAT 15.0404</p>
|
|
<p>No test (no treatment): 14.9961</p>
|
|
<p>No test (treat everyone): 15.0470</p>
|
|
<p>Batch PCR (treat): 15.0450</p>
|
|
<p>Batch PCR (wait): 15.0241</p>
|
|
<p>Clinical judgement: 15.0145</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_6 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">N/A</td><td headers="hd_h_niceng237er2.tab9_1_1_1_7 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Costs of treatment and diagnostics had little impact on the cost-effectiveness compared to diagnostic test parameters, treatment benefits and the seasonal prevalence of influenza. If upper limits for sensitivity and specificity are used, batch PCR (treat)<sup>a</sup> was the most cost-effective.</td><td headers="hd_h_niceng237er2.tab9_1_1_1_8 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Treating everyone in a high-risk population without a rapid test provides the highest NHB. Of the three rapid tests, NAAT to inform treatment was the most cost-effective. Difference in QALYs between the strategies is minimal.</td></tr><tr><td headers="hd_h_niceng237er2.tab9_1_1_1_1 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Rothberg, 2003a<a class="bibr" href="#niceng237er2.ref56" rid="niceng237er2.ref56"><sup>56</sup></a></td><td headers="hd_h_niceng237er2.tab9_1_1_1_2 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Rapid antigen tests (Directigen A/B; Flu OIA; QuickVue; ZstatFlu); followed by different antiviral therapies</td><td headers="hd_h_niceng237er2.tab9_1_1_1_3 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Influenza A and B</td><td headers="hd_h_niceng237er2.tab9_1_1_1_4 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Exact figures not stated for all strategies (presented as a figure); all testing strategies increase costs</td><td headers="hd_h_niceng237er2.tab9_1_1_1_5 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Exact figures not stated for all strategies (presented as a figure); all testing strategies led to negative QALYs</td><td headers="hd_h_niceng237er2.tab9_1_1_1_6 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">N/A</td><td headers="hd_h_niceng237er2.tab9_1_1_1_7 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Results sensitive to efficacy of the drugs and the cost of a workday. Decreasing the utility of influenza slightly improved cost-effectiveness of NAI. The lowest priced test is preferred with a slight preference for Directigen. The preferred strategy is affected by the prevalence of influenza.</td><td headers="hd_h_niceng237er2.tab9_1_1_1_8 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">All of the cost-effective strategies involve treatment based on clinical diagnosis. We did find a limited role for testing when the probability of influenza infection is low, as in the peri-influenza season, and most cases are caused by influenza B.</td></tr><tr><td headers="hd_h_niceng237er2.tab9_1_1_1_1 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Rothberg, 2003b<a class="bibr" href="#niceng237er2.ref57" rid="niceng237er2.ref57"><sup>57</sup></a></td><td headers="hd_h_niceng237er2.tab9_1_1_1_2 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Rapid antigen test QuickVue; followed by different antiviral therapies</td><td headers="hd_h_niceng237er2.tab9_1_1_1_3 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Influenza A and B</td><td headers="hd_h_niceng237er2.tab9_1_1_1_4 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
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|
<p>Costs for unvaccinated patient aged 75y</p>
|
|
<p>Test+ antiviral treatment: $137.35-$147.94</p>
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<p>No test, no antiviral treatment: $118.86</p>
|
|
<p>No test antiviral treatment: $120.43-$155.56</p>
|
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</td><td headers="hd_h_niceng237er2.tab9_1_1_1_5 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>QALEs for unvaccinated patient aged 75y</p>
|
|
<p>Test+ antiviral treatment: 9.9794-9.9833</p>
|
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<p>No test no antiviral treatment: 9.9783</p>
|
|
<p>No test antiviral treatment: 9.9797-9.9849</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_6 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Test+ antiviral treatment dominated by no test antiviral treatment</td><td headers="hd_h_niceng237er2.tab9_1_1_1_7 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Only vaccination status, the probability that the patient has influenza, the patient’s risk of hospitalisation, and the efficacy of oseltamivir in preventing hospitalisations affected the choice of treatment. The model is insensitive to all other parameters.</td><td headers="hd_h_niceng237er2.tab9_1_1_1_8 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Rapid testing followed by oseltamivir treatment, although less effective than empirical treatment, is cost-effective for low-risk patients and vaccinated patients, especially during the peri-influenza season. Vaccinated low-risk patients should be tested before receiving a NAI.</td></tr><tr><td headers="hd_h_niceng237er2.tab9_1_1_1_1 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Smith, 2002<a class="bibr" href="#niceng237er2.ref58" rid="niceng237er2.ref58"><sup>58</sup></a></td><td headers="hd_h_niceng237er2.tab9_1_1_1_2 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Rapid test; followed by different antiviral therapies</td><td headers="hd_h_niceng237er2.tab9_1_1_1_3 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Influenza A and B</td><td headers="hd_h_niceng237er2.tab9_1_1_1_4 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
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|
<p>Costs per patient Test+ antiviral treatment: $115-$134.30</p>
|
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<p>No test, no antiviral treatment: $92.50</p>
|
|
<p>No test, antiviral treatment: $97.50-$137.10</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_5 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
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|
<p>QALDs lost per patient: Test+ antiviral treatment 1.59-1.75</p>
|
|
<p>No test, no antiviral treatment: 2.11</p>
|
|
<p>No test, antiviral treatment: 1.47-1.69</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_6 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Test+ antiviral treatment dominated by no test antiviral treatment</td><td headers="hd_h_niceng237er2.tab9_1_1_1_7 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Results for treatment with NAI were sensitive to the probability of influenza, influenza A likelihood, influenza utility, untreated influenza duration, rimantadine cost, therapy effect on utility, treated influenza duration, medication side-effect utility, probability of complications and side-effect costs. At a WTP threshold of $100 per QALD, then amantadine or no treatment was favoured. At a WTP threshold of $200-$300, NAIs are favoured in younger patients and rimantadine in older patients. At a WTP of $500, NAIs are favoured.</td><td headers="hd_h_niceng237er2.tab9_1_1_1_8 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Analysis did not favour rapid testing unless the influenza probability is less than 30%. The rapid test was more costly and less effective than treatment without testing. In unvaccinated patients, antiviral therapy without testing is economically reasonable compared with rapid testing or no intervention.</td></tr><tr><td headers="hd_h_niceng237er2.tab9_1_1_1_1 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">You, 2017<a class="bibr" href="#niceng237er2.ref59" rid="niceng237er2.ref59"><sup>59</sup></a></td><td headers="hd_h_niceng237er2.tab9_1_1_1_2 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Rapid molecular PCR to inform antiviral therapy</td><td headers="hd_h_niceng237er2.tab9_1_1_1_3 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Influenza A and B</td><td headers="hd_h_niceng237er2.tab9_1_1_1_4 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Costs per patient</p>
|
|
<p>Test: $116.60</p>
|
|
<p>No test: $83.40</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_5 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>QALYs lost per patient</p>
|
|
<p>Test: 0.00139</p>
|
|
<p>No test: 0.00251</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_6 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">$29,582</td><td headers="hd_h_niceng237er2.tab9_1_1_1_7 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Rapid PCR group remained QALY-saving at a higher cost throughout all sensitivity analyses. Cost-effectiveness of rapid PCR is affected most by: hospitalisation rate in elderly without oseltamivir therapy; odds ratio of hospitalisation with oseltamivir therapy; prevalence of influenza and the age and mortality rate of patients admitted to non-ICU ward. ICERs were above the WTP threshold in 39.5% of simulations.</td><td headers="hd_h_niceng237er2.tab9_1_1_1_8 hd_b_niceng237er2.tab9_1_1_12_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Using rapid PCR for the detection of influenza in elderly patients with influenza-like illness at outpatient clinics appears to be a cost-effective option to reduce hospitalisation and mortality rate. This strategy also saves QALYs from the healthcare provider perspective in Hong Kong. The prevalence of influenza should be higher than 14.3% for the rapid PCR to be effective.</td></tr><tr><th headers="hd_h_niceng237er2.tab9_1_1_1_1 hd_h_niceng237er2.tab9_1_1_1_2 hd_h_niceng237er2.tab9_1_1_1_3 hd_h_niceng237er2.tab9_1_1_1_4 hd_h_niceng237er2.tab9_1_1_1_5 hd_h_niceng237er2.tab9_1_1_1_6 hd_h_niceng237er2.tab9_1_1_1_7 hd_h_niceng237er2.tab9_1_1_1_8" id="hd_b_niceng237er2.tab9_1_1_18_1" colspan="8" rowspan="1" style="text-align:left;vertical-align:middle;">Other</th></tr><tr><td headers="hd_h_niceng237er2.tab9_1_1_1_1 hd_b_niceng237er2.tab9_1_1_18_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Chew, 2022<a class="bibr" href="#niceng237er2.ref46" rid="niceng237er2.ref46"><sup>46</sup></a></td><td headers="hd_h_niceng237er2.tab9_1_1_1_2 hd_b_niceng237er2.tab9_1_1_18_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Pulse oximetryaided ARI management</td><td headers="hd_h_niceng237er2.tab9_1_1_1_3 hd_b_niceng237er2.tab9_1_1_18_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">ARI</td><td headers="hd_h_niceng237er2.tab9_1_1_1_4 hd_b_niceng237er2.tab9_1_1_18_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Cost savings per year with pulse oximetry were $52,944</td><td headers="hd_h_niceng237er2.tab9_1_1_1_5 hd_b_niceng237er2.tab9_1_1_18_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">DALYs averted per year with pulse oximetry were 0.9</td><td headers="hd_h_niceng237er2.tab9_1_1_1_6 hd_b_niceng237er2.tab9_1_1_18_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">N/A</td><td headers="hd_h_niceng237er2.tab9_1_1_1_7 hd_b_niceng237er2.tab9_1_1_18_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Cost savings robust across all sensitivity analyses. Where pulse oximetry had only a slight increase in sensitivity and specificity over clinical judgement there were still cost savings.</td><td headers="hd_h_niceng237er2.tab9_1_1_1_8 hd_b_niceng237er2.tab9_1_1_18_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Supplementing standard care with pulse oximetry is a costeffective way of saving lives in Northern Thailand and reducing antibiotic over-use. The WHO guideline could be extended to cover all ages.</td></tr><tr><td headers="hd_h_niceng237er2.tab9_1_1_1_1 hd_b_niceng237er2.tab9_1_1_18_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Michaelidis, 2014<a class="bibr" href="#niceng237er2.ref52" rid="niceng237er2.ref52"><sup>52</sup></a></td><td headers="hd_h_niceng237er2.tab9_1_1_1_2 hd_b_niceng237er2.tab9_1_1_18_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">POC procalcitonin-guided antibiotic therapy</td><td headers="hd_h_niceng237er2.tab9_1_1_1_3 hd_b_niceng237er2.tab9_1_1_18_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">ARTIs</td><td headers="hd_h_niceng237er2.tab9_1_1_1_4 hd_b_niceng237er2.tab9_1_1_18_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
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<p>Costs per patient</p>
|
|
<p>Patients judged to require antibiotics:</p>
|
|
<p>Test $51</p>
|
|
<p>No test $29</p>
|
|
<p>Prior to any antibiotic decision:</p>
|
|
<p>Test: $49</p>
|
|
<p>No test $15</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_5 hd_b_niceng237er2.tab9_1_1_18_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>QALYs per patient</p>
|
|
<p>Patients judged to require antibiotics:</p>
|
|
<p>Test: 0.00746</p>
|
|
<p>No test: 0.00765</p>
|
|
<p>Prior to any antibiotic decision:</p>
|
|
<p>Test: 0.00743</p>
|
|
<p>No test: 0.00749</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_6 hd_b_niceng237er2.tab9_1_1_18_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Patients judged to require antibiotics: $118,828</p>
|
|
<p>Prior to any antibiotic decision: $575,249</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_7 hd_b_niceng237er2.tab9_1_1_18_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">None conducted for cost-utility analyses.</td><td headers="hd_h_niceng237er2.tab9_1_1_1_8 hd_b_niceng237er2.tab9_1_1_18_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Testing is unlikely to be preferred over usual care based on cost alone. However, it is likely to be cost-effective when the costs of antibiotic resistance are considered and if the test is only used in those judged to require antibiotics as testing becomes more favoured as antibiotic costs increase, test costs decrease and physician adherence increases.</td></tr><tr><td headers="hd_h_niceng237er2.tab9_1_1_1_1 hd_b_niceng237er2.tab9_1_1_18_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Nicholson, 2014<a class="bibr" href="#niceng237er2.ref54" rid="niceng237er2.ref54"><sup>54</sup></a></td><td headers="hd_h_niceng237er2.tab9_1_1_1_2 hd_b_niceng237er2.tab9_1_1_18_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Rapid nearpatient diagnostic tests (Quidel for influenza, and BinaxNOW for the pneumococcal antigen)</td><td headers="hd_h_niceng237er2.tab9_1_1_1_3 hd_b_niceng237er2.tab9_1_1_18_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Influenza A and B, respiratory syncytial virus and pneumococcal infection</td><td headers="hd_h_niceng237er2.tab9_1_1_1_4 hd_b_niceng237er2.tab9_1_1_18_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Cost per patient:</p>
|
|
<p>PCR: £1,978</p>
|
|
<p>Traditional: £2,327</p>
|
|
<p>POCT: £2,159</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_5 hd_b_niceng237er2.tab9_1_1_18_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>QALYs per patient</p>
|
|
<p>PCR: 0.007779</p>
|
|
<p>Traditional: 0.007588</p>
|
|
<p>POCT: 0.008035</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_6 hd_b_niceng237er2.tab9_1_1_18_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Traditional laboratory culture dominated.</p>
|
|
<p>POCT compared to PCR: £734,717</p>
|
|
</td><td headers="hd_h_niceng237er2.tab9_1_1_1_7 hd_b_niceng237er2.tab9_1_1_18_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Price reduction of the tests has a relatively small impact on results. Ranking of the strategies remains the same as the base case. Probabilities (of error) of being cost-effective at WTP thresholds of £20,000 and £30,000 respectively are 0.183 and 0.186 for the POCT; 0.783 and 0.781 for PCR and 0.034 and 0.033 for the traditional strategy.</td><td headers="hd_h_niceng237er2.tab9_1_1_1_8 hd_b_niceng237er2.tab9_1_1_18_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">There is relatively little difference in the cost distributions or QALYs gained between the three diagnostic strategies. Using traditional laboratory culture is the most expensive and is also associated with the lowest gain in terms of QALYs. Although POCT has the highest gain in terms of QALYs, this gain over PCR is not offset by its higher cost at current thresholds of WTP.</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">CRP – C-reacve protein; NAAT – nucleic acid amplificaon tests; PCR – polymerase chain reacon; OIA – opcal immunoassay; DIA – digital immunoassays; RIDT – rapid influenza diagnosc tests; POCT – point-of-care test; ARI – acute respiratory infecon; NAI – neuraminidase inhibitors; RTI – respiratory tract infecon; LRTI – lower respiratory tract infecon; COPD – chronic obstrucve pulmonary disorder; QALYs – quality-adjusted life years; QALDs – quality-adjusted life days; QALEs – quality-adjusted life expectancy; ICER – incremental cost-effecveness rao; WTP – willingness to pay; NMB – net monetary benefit; CEAC – cost-effecveness acceptability curve; HRQoL – health related quality of life; GP – general praconer; NICE – Naonal Instute for Health and Care Excellence.</p></div></dd></dl><dl class="bkr_refwrap"><dt>a</dt><dd><div id="niceng237er2.tab9_1"><p class="no_margin">Batch PCR and treat everyone unl results become available,</p></div></dd></dl><dl class="bkr_refwrap"><dt>b</dt><dd><div id="niceng237er2.tab9_2"><p class="no_margin">Batch PCR and wait unl results are available before making treatment decisions,</p></div></dd></dl><dl class="bkr_refwrap"><dt>c</dt><dd><div id="niceng237er2.tab9_3"><p class="no_margin">ARTI judged by their doctor to require anbiocs,</p></div></dd></dl><dl class="bkr_refwrap"><dt>d</dt><dd><div id="niceng237er2.tab9_4"><p class="no_margin">ARTI prior to any decision about anbiocs</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobniceng237er2tab10"><div id="niceng237er2.tab10" class="table"><h3><span class="label">Table 10</span><span class="title">Crical appraisal of included cost ulity studies</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK598986/table/niceng237er2.tab10/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng237er2.tab10_lrgtbl__"><table><thead><tr><th id="hd_h_niceng237er2.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Author, Year</th><th id="hd_h_niceng237er2.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">1. Was a well-defined question posed in answerable form?</th><th id="hd_h_niceng237er2.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">2. Was a comprehensive description of the competing alternatives given?</th><th id="hd_h_niceng237er2.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">3. Was the effectiveness of the programmes or services established?</th><th id="hd_h_niceng237er2.tab10_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">4. Were all the important and relevant costs and consequences for each alternative identified?</th><th id="hd_h_niceng237er2.tab10_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">5. Were costs and consequences measured accurately in appropriate physical units?</th><th id="hd_h_niceng237er2.tab10_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">6. Were the costs and consequences valued credibly?</th><th id="hd_h_niceng237er2.tab10_1_1_1_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">7. Were costs and consequences adjusted for differential timings?</th><th id="hd_h_niceng237er2.tab10_1_1_1_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">8. Was an incremental analysis of costs and consequences of alternatives performed?</th><th id="hd_h_niceng237er2.tab10_1_1_1_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">9. Was uncertainty in the estimates of costs and consequences adequately characterised?</th><th id="hd_h_niceng237er2.tab10_1_1_1_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">10. Did the presentation and discussion of study results include all issues of concern to users?</th></tr></thead><tbody><tr><td headers="hd_h_niceng237er2.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Billir, 2021</td><td headers="hd_h_niceng237er2.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✕</td><td headers="hd_h_niceng237er2.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">?</td><td headers="hd_h_niceng237er2.tab10_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
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<p>Short ?</p>
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<p>Long ✕</p>
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<p>AMR ✕</p>
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|
</td><td headers="hd_h_niceng237er2.tab10_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">?</td><td headers="hd_h_niceng237er2.tab10_1_1_1_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">NA</td><td headers="hd_h_niceng237er2.tab10_1_1_1_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td></tr><tr><td headers="hd_h_niceng237er2.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Chew, 2022</td><td headers="hd_h_niceng237er2.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✕</td><td headers="hd_h_niceng237er2.tab10_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
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<p>Short ✕</p>
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<p>Long ✕</p>
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<p>AMR ✓</p>
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</td><td headers="hd_h_niceng237er2.tab10_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">?</td><td headers="hd_h_niceng237er2.tab10_1_1_1_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">NA</td><td headers="hd_h_niceng237er2.tab10_1_1_1_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✕</td><td headers="hd_h_niceng237er2.tab10_1_1_1_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td></tr><tr><td headers="hd_h_niceng237er2.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Francis, 2020</td><td headers="hd_h_niceng237er2.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
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<p>Short ✓</p>
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<p>Long ✕</p>
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|
<p>AMR ✕</p>
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</td><td headers="hd_h_niceng237er2.tab10_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">NA</td><td headers="hd_h_niceng237er2.tab10_1_1_1_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td></tr><tr><td headers="hd_h_niceng237er2.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Fraser, 2020</td><td headers="hd_h_niceng237er2.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
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<p>Short ✓</p>
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<p>Long ✕</p>
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<p>AMR ✕</p>
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</td><td headers="hd_h_niceng237er2.tab10_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">NA</td><td headers="hd_h_niceng237er2.tab10_1_1_1_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td></tr><tr><td headers="hd_h_niceng237er2.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Holmes, 2018</td><td headers="hd_h_niceng237er2.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
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<p>Short ✓</p>
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<p>Long ✕</p>
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<p>AMR ✓</p>
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</td><td headers="hd_h_niceng237er2.tab10_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">NA</td><td headers="hd_h_niceng237er2.tab10_1_1_1_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td></tr><tr><td headers="hd_h_niceng237er2.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Hunter, 2015</td><td headers="hd_h_niceng237er2.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
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<p>Short ✓</p>
|
|
<p>Long ✓</p>
|
|
<p>AMR ✕</p>
|
|
</td><td headers="hd_h_niceng237er2.tab10_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td></tr><tr><td headers="hd_h_niceng237er2.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Little, 2014</td><td headers="hd_h_niceng237er2.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✕</td><td headers="hd_h_niceng237er2.tab10_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Short ✓</p>
|
|
<p>Long ✕</p>
|
|
<p>AMR ✕</p>
|
|
</td><td headers="hd_h_niceng237er2.tab10_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">NA</td><td headers="hd_h_niceng237er2.tab10_1_1_1_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✕</td><td headers="hd_h_niceng237er2.tab10_1_1_1_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td></tr><tr><td headers="hd_h_niceng237er2.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Mac, 2020</td><td headers="hd_h_niceng237er2.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">?</td><td headers="hd_h_niceng237er2.tab10_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Short ?</p>
|
|
<p>Long ?</p>
|
|
<p>AMR ✕</p>
|
|
</td><td headers="hd_h_niceng237er2.tab10_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✕</td><td headers="hd_h_niceng237er2.tab10_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">?</td><td headers="hd_h_niceng237er2.tab10_1_1_1_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td></tr><tr><td headers="hd_h_niceng237er2.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Michaelidis, 2013</td><td headers="hd_h_niceng237er2.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✕</td><td headers="hd_h_niceng237er2.tab10_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Short ✕</p>
|
|
<p>Long ✕</p>
|
|
<p>AMR ✕</p>
|
|
</td><td headers="hd_h_niceng237er2.tab10_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">?</td><td headers="hd_h_niceng237er2.tab10_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">?</td><td headers="hd_h_niceng237er2.tab10_1_1_1_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">NA</td><td headers="hd_h_niceng237er2.tab10_1_1_1_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✕</td><td headers="hd_h_niceng237er2.tab10_1_1_1_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td></tr><tr><td headers="hd_h_niceng237er2.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Neuner, 2003</td><td headers="hd_h_niceng237er2.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Short ✓</p>
|
|
<p>Long ✕</p>
|
|
<p>AMR ✕</p>
|
|
</td><td headers="hd_h_niceng237er2.tab10_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">NA</td><td headers="hd_h_niceng237er2.tab10_1_1_1_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td></tr><tr><td headers="hd_h_niceng237er2.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Nicholson, 2014</td><td headers="hd_h_niceng237er2.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">?</td><td headers="hd_h_niceng237er2.tab10_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Short ✓</p>
|
|
<p>Long ✕</p>
|
|
<p>AMR ✕</p>
|
|
</td><td headers="hd_h_niceng237er2.tab10_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">?</td><td headers="hd_h_niceng237er2.tab10_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">?</td><td headers="hd_h_niceng237er2.tab10_1_1_1_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">NA</td><td headers="hd_h_niceng237er2.tab10_1_1_1_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✕</td><td headers="hd_h_niceng237er2.tab10_1_1_1_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td></tr><tr><td headers="hd_h_niceng237er2.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Oppong, 2013</td><td headers="hd_h_niceng237er2.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">?</td><td headers="hd_h_niceng237er2.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">?</td><td headers="hd_h_niceng237er2.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✕</td><td headers="hd_h_niceng237er2.tab10_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Short</p>
|
|
<p>Long ✕</p>
|
|
<p>AMR ✕</p>
|
|
</td><td headers="hd_h_niceng237er2.tab10_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✕</td><td headers="hd_h_niceng237er2.tab10_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">?</td><td headers="hd_h_niceng237er2.tab10_1_1_1_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">NA</td><td headers="hd_h_niceng237er2.tab10_1_1_1_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✕</td><td headers="hd_h_niceng237er2.tab10_1_1_1_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✕</td></tr><tr><td headers="hd_h_niceng237er2.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Rothberg, 2003a</td><td headers="hd_h_niceng237er2.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">?</td><td headers="hd_h_niceng237er2.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">?</td><td headers="hd_h_niceng237er2.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✕</td><td headers="hd_h_niceng237er2.tab10_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Short</p>
|
|
<p>Long ✕</p>
|
|
<p>AMR ✕</p>
|
|
</td><td headers="hd_h_niceng237er2.tab10_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✕</td><td headers="hd_h_niceng237er2.tab10_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">?</td><td headers="hd_h_niceng237er2.tab10_1_1_1_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">?</td><td headers="hd_h_niceng237er2.tab10_1_1_1_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✕</td></tr><tr><td headers="hd_h_niceng237er2.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Rothberg, 2003b</td><td headers="hd_h_niceng237er2.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">?</td><td headers="hd_h_niceng237er2.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">?</td><td headers="hd_h_niceng237er2.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✕</td><td headers="hd_h_niceng237er2.tab10_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Short</p>
|
|
<p>Long ✕</p>
|
|
<p>AMR ✕</p>
|
|
</td><td headers="hd_h_niceng237er2.tab10_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">NA</td><td headers="hd_h_niceng237er2.tab10_1_1_1_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td></tr><tr><td headers="hd_h_niceng237er2.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Smith, 2002</td><td headers="hd_h_niceng237er2.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">?</td><td headers="hd_h_niceng237er2.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">?</td><td headers="hd_h_niceng237er2.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">?</td><td headers="hd_h_niceng237er2.tab10_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Short</p>
|
|
<p>Long ✕</p>
|
|
<p>AMR</p>
|
|
</td><td headers="hd_h_niceng237er2.tab10_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✕</td><td headers="hd_h_niceng237er2.tab10_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✕</td><td headers="hd_h_niceng237er2.tab10_1_1_1_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">NA</td><td headers="hd_h_niceng237er2.tab10_1_1_1_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td></tr><tr><td headers="hd_h_niceng237er2.tab10_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">You, 2017</td><td headers="hd_h_niceng237er2.tab10_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">?</td><td headers="hd_h_niceng237er2.tab10_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✕</td><td headers="hd_h_niceng237er2.tab10_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">
|
|
<p>Short ?</p>
|
|
<p>Long ?</p>
|
|
<p>AMR ✕</p>
|
|
</td><td headers="hd_h_niceng237er2.tab10_1_1_1_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">?</td><td headers="hd_h_niceng237er2.tab10_1_1_1_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td><td headers="hd_h_niceng237er2.tab10_1_1_1_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">✓</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng237er2app4tab1"><div id="niceng237er2.app4.tab1" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK598986/table/niceng237er2.app4.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng237er2.app4.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Full reference</th><th id="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Reason for exclusion</th></tr></thead><tbody><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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Aabenhus
|
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R, Jensen
|
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JU, Jorgensen
|
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KJ, Hrobjartsson
|
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A, Bjerrum
|
|
L. Biomarkers as point-of-care tests to guide prescription of antibiotics in patients with acute respiratory infections in primary care. Cochrane Database Syst Rev. 2014(11):CD010130.
|
|
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/25374293" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25374293</span></a>]
|
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</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Updated by Smedemark 2022 Cochrane Review.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Abraham
|
|
MK, Perkins
|
|
J, Vilke
|
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GM, Coyne
|
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CJ. Influenza in the Emergency Department: Vaccination, Diagnosis, and Treatment: Clinical Practice Paper Approved by American Academy of Emergency Medicine Clinical Guidelines Committee. J Emerg Med. 2016;<strong>50</strong>(3):536–42.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/26763858" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26763858</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – no relevant outcomes reported (limited outcome data – diagnostic accuracy data).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Alter
|
|
DN. Point-of-Care Testing for the Emergency Department Patient: Quantity and Quality of the Available Evidence. Arch Pathol Lab Med. 2021;<strong>145</strong>(3):308–19.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/33635952" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33635952</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – no relevant outcomes reported (inpatient LOS, change in testing practice, change in treatment plan, disposition, or use of additional diagnostic services).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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Bernstein
|
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DI, Mejias
|
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A, Rath
|
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B, Woods
|
|
CW, Deeter
|
|
JP. Summarizing Study Characteristics and Diagnostic Performance of Commercially Available Tests for Respiratory Syncytial Virus: A Scoping Literature Review in the COVID-19 Era. The Journal of Applied Laboratory Medicine
|
|
2023;<strong>8</strong>(2):353–371.
|
|
[<a href="/pmc/articles/PMC9384538/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9384538</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/35854475" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35854475</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – no relevant outcomes reported (diagnostic accuracy data only).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Bouzid
|
|
D, Zanella
|
|
MC, Kerneis
|
|
S, Visseaux
|
|
B, May
|
|
L, Schrenzel
|
|
J, et al. Rapid diagnostic tests for infectious diseases in the emergency department. Clin Microbiol Infect. 2021;<strong>27</strong>(2):182–91.
|
|
[<a href="/pmc/articles/PMC7129254/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7129254</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32120036" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32120036</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – no relevant outcomes reported (diagnostic accuracy data only).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Bruning
|
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AHL, Leeflang
|
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MMG, Vos
|
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J, Spijker
|
|
R, de Jong
|
|
MD, Wolthers
|
|
KC, et al. Rapid Tests for Influenza, Respiratory Syncytial Virus, and Other Respiratory Viruses: A Systematic Review and Meta-analysis. Clin Infect Dis. 2017;<strong>65</strong>(6):1026–32.
|
|
[<a href="/pmc/articles/PMC7108103/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7108103</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28520858" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28520858</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – no relevant outcomes reported (diagnostic accuracy data only).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Carlton
|
|
HC, Savovic
|
|
J, Dawson
|
|
S, Mitchelmore
|
|
PJ, Elwenspoek
|
|
MMC. Novel point-of-care biomarker combination tests to differentiate acute bacterial from viral respiratory tract infections to guide antibiotic prescribing: a systematic review. Clin Microbiol Infect. 2021;<strong>27</strong>(8):1096–108.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/34015531" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34015531</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – no relevant outcomes reported (diagnostic accuracy data only).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Chartrand
|
|
C, Leeflang
|
|
MM, Minion
|
|
J, Brewer
|
|
T, Pai
|
|
M. Accuracy of rapid influenza diagnostic tests: a meta-analysis. Ann Intern Med. 2012;<strong>156</strong>(7):500–11.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/22371850" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22371850</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – no relevant outcomes reported (diagnostic accuracy data only).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Chartrand
|
|
C, Tremblay
|
|
N, Renaud
|
|
C, Papenburg
|
|
J. Diagnostic Accuracy of Rapid Antigen Detection Tests for Respiratory Syncytial Virus Infection: Systematic Review and Meta-analysis. J Clin Microbiol. 2015;<strong>53</strong>(12):3738–49.
|
|
[<a href="/pmc/articles/PMC4652120/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4652120</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26354816" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26354816</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – no relevant outcomes reported (diagnostic accuracy data only).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Clark
|
|
TW, Lindsley
|
|
K, Wigmosta
|
|
TB, Bhagat
|
|
A, Hemmert
|
|
RB, Uye
|
|
J, et al. Rapid multiplex PCR for respiratory viruses reduces time to result and improves clinical care: Results of a systematic review and meta-analysis. Journal of Infection
|
|
2023;<strong>86</strong>(5):462–475.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/36906153" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36906153</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention – not all POC tests; subgroup analysis was planned but not performed due to lack of evidence.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Cohen
|
|
JF, Pauchard
|
|
JY, Hjelm
|
|
N, Cohen
|
|
R, Chalumeau
|
|
M. Efficacy and safety of rapid tests to guide antibiotic prescriptions for sore throat. Cochrane Database Syst Rev. 2020;<strong>6</strong>:CD012431.
|
|
[<a href="/pmc/articles/PMC7271976/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7271976</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32497279" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32497279</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – subgroup analyses in adults only not conducted for relevant outcomes.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Cooke
|
|
J, Butler
|
|
C, Hopstaken
|
|
R, Dryden
|
|
MS, McNulty
|
|
C, Hurding
|
|
S, et al. Narrative review of primary care point-of-care testing (POCT) and antibacterial use in respiratory tract infection (RTI). BMJ Open Respir Res. 2015;<strong>2</strong>(1):e000086. [<a href="/pmc/articles/PMC4426285/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4426285</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25973210" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25973210</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes - relevant studies not synthesised quantitatively; includes diagnostic accuracy outcome data.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Cooke
|
|
J, Llor
|
|
C, Hopstaken
|
|
R, Dryden
|
|
M, Butler
|
|
C. Respiratory tract infections (RTIs) in primary care: narrative review of C reactive protein (CRP) point-of-care testing (POCT) and antibacterial use in patients who present with symptoms of RTI. BMJ Open Respir Res. 2020;<strong>7</strong>(1):09. [<a href="/pmc/articles/PMC7476490/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7476490</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32895246" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32895246</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes - relevant studies not synthesised quantitatively.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Delaney
|
|
BC, Hyde
|
|
CJ, McManus
|
|
RJ, Wilson
|
|
S, Fitzmaurice
|
|
DA, Jowett
|
|
S, et al. Systematic review of near patient test evaluations in primary care. BMJ
|
|
1999;<strong>319</strong>(7213):824–7.
|
|
[<a href="/pmc/articles/PMC314212/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC314212</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/10496828" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10496828</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes - relevant impact studies not synthesised quantitatively.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Dubois
|
|
C, Smeesters
|
|
PR, Refes
|
|
Y, Levy
|
|
C, Bidet
|
|
P, Cohen
|
|
R, et al. Diagnostic accuracy of rapid nucleic acid tests for group A streptococcal pharyngitis: systematic review and meta-analysis. Clin Microbiol Infect. 2021;<strong>27</strong>(12):1736–45.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/33964409" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33964409</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – no relevant outcomes reported (diagnostic accuracy data only).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Egilmezer
|
|
E, Walker
|
|
GJ, Bakthavathsalam
|
|
P, Peterson
|
|
JR, Gooding
|
|
JJ, Rawlinson
|
|
W, et al. Systematic review of the impact of point-of-care testing for influenza on the outcomes of patients with acute respiratory tract infection. Rev Med Virol. 2018;<strong>28</strong>(5):e1995.
|
|
[<a href="/pmc/articles/PMC7169080/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7169080</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30101552" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30101552</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population – mixed age population with influenza-like illness in mixed settings.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Engel
|
|
MF, Paling
|
|
FP, Hoepelman
|
|
AI, van der Meer
|
|
V, Oosterheert
|
|
JJ. Evaluating the evidence for the implementation of C-reactive protein measurement in adult patients with suspected lower respiratory tract infection in primary care: a systematic review. Fam Pract. 2012;<strong>29</strong>(4):383–93.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/22159030" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22159030</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes - relevant studies not synthesised quantitatively.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Fraser
|
|
H, Gallacher
|
|
D, Achana
|
|
F, Court
|
|
R, Taylor-Phillips
|
|
S, Nduka
|
|
C, et al. Rapid antigen detection and molecular tests for group A streptococcal infections for acute sore throat: systematic reviews and economic evaluation. Health Technol Assess. 2020;<strong>24</strong>(31):1–232. [<a href="/pmc/articles/PMC7355404/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7355404</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32605705" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32605705</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – most studies reporting diagnostic accuracy data; clinical outcome studies include mixed age population.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Gentilotti
|
|
E, De Nardo
|
|
P, Cremonini
|
|
E, Gorska
|
|
A, Mazzaferri
|
|
F, Canziani
|
|
LM, et al. Diagnostic accuracy of point-of-care tests in acute community-acquired lower respiratory tract infections. A systematic review and meta-analysis. Clinical Microbiology & Infection
|
|
2022;<strong>28</strong>(1): 13–22.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/34601148" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34601148</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – no relevant outcomes reported (diagnostic accuracy data only).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Goyder
|
|
C, Tan
|
|
PS, Verbakel
|
|
J, Ananthakumar
|
|
T, Lee
|
|
JJ, Hayward
|
|
G, et al. Impact of point-of-care panel tests in ambulatory care: a systematic review and meta-analysis. BMJ Open
|
|
2020;<strong>10</strong>:e032132. [<a href="/pmc/articles/PMC7050348/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7050348</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32111610" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32111610</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population – not patients with ARI (includes all patients presenting to the ED).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Gubbins
|
|
PO, Klepser
|
|
ME, Adams
|
|
AJ, Jacobs
|
|
DM, Percival
|
|
KM, Tallman
|
|
GB. Potential for Pharmacy-Public Health Collaborations Using Pharmacy-Based Point-of-Care Testing Services for Infectious Diseases. J Public Health Manag Pract. 2017;<strong>23</strong>(6):593–600.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/27997479" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27997479</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – not a systematic review.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Han
|
|
MY, Xie
|
|
TA, Li
|
|
JX, Chen
|
|
HJ, Yang
|
|
XH, Guo
|
|
XG. Evaluation of Lateral-Flow Assay for Rapid Detection of Influenza Virus. Biomed Res Int. 2020;<strong>2020</strong>:3969868.
|
|
[<a href="/pmc/articles/PMC7495160/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7495160</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32964030" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32964030</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – no relevant outcomes reported (diagnostic accuracy data only).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Hankey
|
|
B, Riley
|
|
B. BET 1: use of a procalcitonin algorithm to guide antimicrobial therapy in COPD exacerbations can reduce antibiotic consumption with no increase in rates of treatment failure or mortality. Emergency medicine journal : EMJ. 2015;<strong>32</strong>(6):493–5.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/25991774" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25991774</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication type – Editorial/commentary.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Hey
|
|
J, Thompson-Leduc
|
|
P, Kirson
|
|
NY, Zimmer
|
|
L, Wilkins
|
|
D, Rice
|
|
B, et al. Procalcitonin guidance in patients with lower respiratory tract infections: a systematic review and meta-analysis. Clinical chemistry and laboratory medicine. 2018;<strong>56</strong>(8):1200–9.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/29715176" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29715176</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population – includes inpatients; no subgroup analysis in relevant population.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Huang
|
|
Y, Chen
|
|
R, Wu
|
|
T, Wei
|
|
X, Guo
|
|
A. Association between point-of-care CRP testing and antibiotic prescribing in respiratory tract infections: a systematic review and meta-analysis of primary care studies. The British journal of general practice : the journal of the Royal College of General Practitioners
|
|
2013;<strong>63</strong>(616):e787–e794.
|
|
[<a href="/pmc/articles/PMC3809432/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3809432</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24267862" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24267862</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population – includes mixed age population; no subgroup analysis in adults only.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Huang
|
|
HS, Tsai
|
|
CL, Chang
|
|
J, Hsu
|
|
TC, Lin
|
|
S, Lee
|
|
CC. Multiplex PCR system for the rapid diagnosis of respiratory virus infection: systematic review and meta-analysis. Clin Microbiol Infect. 2018;<strong>24</strong>(10):1055–63.
|
|
[<a href="/pmc/articles/PMC7128951/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7128951</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29208560" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29208560</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – compares diagnostic accuracy of three rapid multiplex PCR tests.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Joseph
|
|
P, Godofsky
|
|
E. Outpatient Antibiotic Stewardship: A Growing Frontier-Combining Myxovirus Resistance Protein A With Other Biomarkers to Improve Antibiotic Use. Open forum infect. 2018;<strong>5</strong>(2):ofy024. [<a href="/pmc/articles/PMC5815119/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5815119</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29479553" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29479553</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – not a systematic review.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Joshi
|
|
A, Perin
|
|
DP, Gehle
|
|
A, Nsiah-Kumi
|
|
PA. Feasibility of using C-reactive protein for point-of-care testing. Technol Health Care. 2013;<strong>21</strong>(3):233–40.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/23792796" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23792796</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – limited outcome data reported (frequency data).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kawasaki
|
|
T, Nakagawa
|
|
N, Murata
|
|
M, Yasuo
|
|
S, Yoshida
|
|
T, Ando
|
|
K, et al. Diagnostic accuracy of urinary antigen tests for legionellosis: A systematic review and meta-analysis. Respiratory Investigation
|
|
2022;<strong>60</strong>(2): 205–214.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/34972680" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34972680</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – no relevant outcomes reported (diagnostic accuracy data only).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ko
|
|
F, Drews
|
|
SJ. The impact of commercial rapid respiratory virus diagnostic tests on patient outcomes and health system utilization. Expert Rev Mol Diagn. 2017;<strong>17</strong>(10):917–31.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/28841814" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28841814</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – not a systematic review.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kochling
|
|
A, Loffler
|
|
C, Reinsch
|
|
S, Hornung
|
|
A, Bohmer
|
|
F, Altiner
|
|
A, et al. Reduction of antibiotic prescriptions for acute respiratory tract infections in primary care: a systematic review. Implement Sci. 2018;<strong>13</strong>(1):47.
|
|
[<a href="/pmc/articles/PMC5859410/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5859410</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29554972" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29554972</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention – includes POC tests and non-POC tests; relevant studies not synthesised quantitatively.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Koski
|
|
RR, Klepser
|
|
ME. A systematic review of rapid diagnostic tests for influenza: considerations for the community pharmacist. J Am Pharm Assoc (2003). 2017;<strong>57</strong>(1):13–9.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/27836481" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27836481</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – no relevant outcomes reported (diagnostic accuracy data only).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Lean
|
|
WL, Arnup
|
|
S, Danchin
|
|
M, Steer
|
|
AC. Rapid diagnostic tests for group A streptococcal pharyngitis: a meta-analysis. Pediatrics. 2014;<strong>134</strong>(4):771–81.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/25201792" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25201792</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – no relevant outcomes reported (diagnostic accuracy data only).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Lee
|
|
JJ, Verbakel
|
|
JY, Goyder
|
|
CR, Ananthakumar
|
|
T, Tan
|
|
PS, Turner
|
|
PJ, et al. The Clinical Utility of Point-of-Care Tests for Influenza in Ambulatory Care: A Systematic Review and Meta-analysis. Clin Infect Dis. 2019;<strong>69</strong>(1):24–33.
|
|
[<a href="/pmc/articles/PMC6579962/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6579962</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30285232" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30285232</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – reports outcomes for non-RCTs and RCTs in children.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Lee
|
|
J, Song
|
|
JU, Kim
|
|
YH. Diagnostic Accuracy of the Quidel Sofia Rapid Influenza Fluorescent Immunoassay in Patients with Influenza-like Illness: A Systematic Review and Meta-analysis. Tuberculosis & Respiratory Diseases
|
|
2021;<strong>84</strong>(3): 226–236.
|
|
[<a href="/pmc/articles/PMC8273023/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8273023</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/33979987" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33979987</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – no relevant outcomes reported (diagnostic accuracy data only).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Lingervelder
|
|
D, Koffijberg
|
|
H, Kusters
|
|
R, MJ
|
|
IJ. Point-of-care testing in primary care: A systematic review on implementation aspects addressed in test evaluations. Int J Clin Pract. 2019;<strong>73</strong>(10):e13392.
|
|
[<a href="/pmc/articles/PMC6790572/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6790572</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31313873" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31313873</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population – not limited to patients with ARI; no subgroup analysis conducted in relevant population.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Little
|
|
P, Hobbs
|
|
FD, Moore
|
|
M, Mant
|
|
D, Williamson
|
|
I, McNulty
|
|
C, et al. PRImary care Streptococcal Management (PRISM) study: in vitro study, diagnostic cohorts and a pragmatic adaptive randomised controlled trial with nested qualitative study and cost-effectiveness study. Health Technol Assess. 2014;<strong>18</strong>(6):vii–xxv, 1–101. [<a href="/pmc/articles/PMC4781545/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4781545</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24467988" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24467988</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – not a systematic review.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Marchello
|
|
CS, Ebell
|
|
MH, Dale
|
|
AP, Harvill
|
|
ET, Shen
|
|
Y, Whalen
|
|
CC. Signs and Symptoms That Rule out Community-Acquired Pneumonia in Outpatient Adults: A Systematic Review and Meta-Analysis. J Am Board Fam Med. 2019;<strong>32</strong>(2):234–47.
|
|
[<a href="/pmc/articles/PMC7422644/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7422644</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30850460" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30850460</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention - Clinical decision rule (including POC test) to diagnose, predict or rule out community-acquired pneumonia.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Martínez-González
|
|
NA, Coenen
|
|
S, Plate
|
|
A, Colliers
|
|
A, Rosemann
|
|
T, Senn
|
|
O, Neuner-Jehle
|
|
S. The impact of interventions to improve the quality of prescribing and use of antibiotics in primary care patients with respiratory tract infections: a systematic review protocol. BMJ open
|
|
2017;<strong>7</strong>(6), e016253. [<a href="/pmc/articles/PMC5726136/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5726136</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28611111" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28611111</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication type – protocol only.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Martinez-Gonzalez
|
|
NA, Keizer
|
|
E, Plate
|
|
A, Coenen
|
|
S, Valeri
|
|
F, Verbakel
|
|
JYJ, et al. Point-of-Care C-Reactive Protein Testing to Reduce Antibiotic Prescribing for Respiratory Tract Infections in Primary Care: Systematic Review and Meta-Analysis of Randomised Controlled Trials. Antibiotics (Basel). 2020;<strong>9</strong>(9):16.
|
|
[<a href="/pmc/articles/PMC7559694/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7559694</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32948060" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32948060</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes - relevant studies not synthesised quantitatively.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
McDonagh
|
|
M, Peterson
|
|
K, Winthrop
|
|
K, Cantor
|
|
A, Holzhammer
|
|
B, Buckley
|
|
DI. Agency for Healthcare Research and Quality (US). 2016;<strong>15</strong>(16):01. [<a href="https://pubmed.ncbi.nlm.nih.gov/26913312" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26913312</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes - relevant studies not synthesised quantitatively.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Moore
|
|
C. Point-of-care tests for infection control: should rapid testing be in the laboratory or at the front line?
|
|
J Hosp Infect. 2013;<strong>85</strong>(1):1–7.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/23916892" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23916892</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – no relevant outcomes reported (diagnostic accuracy data only).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Morehouse
|
|
ZP, Chance
|
|
N, Ryan
|
|
GL, Proctor
|
|
CM, Nash
|
|
RJ. A narrative review of nine commercial point of care influenza tests: an overview of methods, benefits, and drawbacks to rapid influenza diagnostic testing. Journal of Osteopathic Medicine
|
|
2023;<strong>123</strong>(1): 39–47.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/35977624" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35977624</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – not a systematic review.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Neuner
|
|
JM, Hamel
|
|
MB, Phillips
|
|
RS, Bona
|
|
K, Aronson
|
|
MD. Diagnosis and management of adults with pharyngitis. A cost-effectiveness analysis. Ann Intern Med. 2003;<strong>139</strong>(2):113–22.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/12859161" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12859161</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – cost-effectiveness analysis.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nicholson
|
|
KG, Abrams
|
|
KR, Batham
|
|
S, Medina
|
|
MJ, Warren
|
|
FC, Barer
|
|
M, et al. Randomised controlled trial and health economic evaluation of the impact of diagnostic testing for influenza, respiratory syncytial virus and Streptococcus pneumoniae infection on the management of acute admissions in the elderly and high-risk 18- to 64-year-olds. Health Technol Assess. 2014;<strong>18</strong>(36):1–274, vii–viii. [<a href="/pmc/articles/PMC4781605/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4781605</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24875092" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24875092</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention – not near patient/rapid POC tests (turnaround time approximately 29 hours).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Odermatt
|
|
J, Friedli
|
|
N, Kutz
|
|
A, Briel
|
|
M, Bucher
|
|
HC, Christ-Crain
|
|
M, et al. Effects of procalcitonin testing on antibiotic use and clinical outcomes in patients with upper respiratory tract infections. An individual patient data meta-analysis. Clinical chemistry and laboratory medicine. 2017;<strong>56</strong>(1):170–7.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/28665787" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28665787</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention – not POC tests (laboratory testing).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Onwuchekwa
|
|
C, Moreo
|
|
LM, Menon
|
|
S, Machado
|
|
B, Curcio
|
|
D, Kalina
|
|
W, et al. Under-ascertainment of Respiratory Syncytial Virus infection in adults due to diagnostic testing limitations: A systematic literature review and meta-analysis. Journal of Infectious Diseases
|
|
2023;<strong>20</strong>:20. [<a href="/pmc/articles/PMC10345483/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC10345483</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/36661222" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36661222</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – diagnostic accuracy of tests (not all relevant POC tests).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Petel
|
|
D, Winters
|
|
N, Gore
|
|
GC, et al. Use of C-reactive protein to tailor antibiotic use: a systematic review and meta-analysis. BMJ Open
|
|
2018;<strong>8</strong>:e022133 [<a href="/pmc/articles/PMC6318522/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6318522</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30580258" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30580258</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes - relevant studies not synthesised quantitatively.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Petrozzino
|
|
JJ, Smith
|
|
C, Atkinson
|
|
MJ. Rapid diagnostic testing for seasonal influenza: an evidence-based review and comparison with unaided clinical diagnosis. J Emerg Med. 2010;<strong>39</strong>(4):476–90.e1.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/20227846" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20227846</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – outcomes not reported separately in adults or relevant setting.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Said
|
|
MA, Johnson
|
|
HL, Nonyane
|
|
BA, Deloria-Knoll
|
|
M, O’Brien
|
|
KL, Andreo
|
|
F, et al. Estimating the burden of pneumococcal pneumonia among adults: a systematic review and meta-analysis of diagnostic techniques. PLoS ONE. 2013;<strong>8</strong>(4):e60273.
|
|
[<a href="/pmc/articles/PMC3615022/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3615022</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/23565216" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23565216</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – no relevant outcomes reported (diagnostic accuracy data only).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Schuetz
|
|
P, Müller
|
|
B, Christ-Crain
|
|
M, Stolz
|
|
D, Tamm
|
|
M, Bouadma
|
|
L, et al. Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections. Cochrane Database of Systematic Reviews
|
|
2012, Issue 9. [<a href="/pmc/articles/PMC6464976/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6464976</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/22972110" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22972110</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Updated by Schuetz 2017 Cochrane Review.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Schuetz
|
|
P, Muller
|
|
B, Christ-Crain
|
|
M, Stolz
|
|
D, Tamm
|
|
M, Bouadma
|
|
L, et al. Procalcitonin to initiate or discontinue antibiotics in acute respiratory tract infections. Cochrane Database of Systematic Reviews
|
|
2017, Issue 10. Art. No: CD007498.
|
|
[<a href="/pmc/articles/PMC6485408/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6485408</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29025194" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29025194</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention – outcomes not reported separately in relevant populations or for relevant POC test (includes inpatients and patients with conditions other than ARIs; tests not all POC tests).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Shaolei
|
|
M, Yujie
|
|
W, Quan
|
|
C, Xiangrong
|
|
Z. A meta-analysis of the diagnostic accuracy of streptocuccus pneumoniae urinary antigen test for adult community acquired streptocuccus pneumoniae pneumoniae. Chinese Critical Care Medicine. 2016;<strong>28</strong>(6):528–33.
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-English language (Chinese).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Solvik
|
|
UO, Boija
|
|
EE, Ekvall
|
|
S, Jabbour
|
|
A, Breivik
|
|
AC, Nordin
|
|
G, et al. Performance and user-friendliness of the rapid antigen detection tests QuickVue Dipstick Strep A test and DIAQUICK Strep A Blue Dipstick for pharyngotonsillitis caused by Streptococcus pyogenes in primary health care. Eur J Clin Microbiol Infect Dis. 2021;<strong>40</strong>(3):549–58.
|
|
[<a href="/pmc/articles/PMC7892498/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7892498</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32996031" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32996031</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – not a systematic review.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Stewart
|
|
EH, Davis
|
|
B, Clemans-Taylor
|
|
BL, Littenberg
|
|
B, Estrada
|
|
CA, Centor
|
|
RM. Rapid antigen group A streptococcus test to diagnose pharyngitis: a systematic review and meta-analysis. PLoS ONE. 2014;<strong>9</strong>(11):e111727.
|
|
[<a href="/pmc/articles/PMC4219770/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4219770</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25369170" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25369170</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – no relevant outcomes reported (diagnostic accuracy data only).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Thornton
|
|
HV, Turner
|
|
KME, Harrison
|
|
S, Hammond
|
|
A, Hawcroft
|
|
C, Hay
|
|
AD. Assessing the potential of upper respiratory tract point-of-care testing: a systematic review of the prognostic significance of upper respiratory tract microbes. Clin Microbiol Infect. 2019;<strong>25</strong>(11):1339–46.
|
|
[<a href="/pmc/articles/PMC7129693/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7129693</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31254715" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31254715</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparator – no relevant comparator.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Timbrook
|
|
TT, Wigmosta
|
|
TB, Hemmert
|
|
RB, Dimas
|
|
JB, Krause
|
|
A, Spinali
|
|
S. Measuring clinical outcomes of highly multiplex molecular diagnostics for respiratory infections: A systematic review and conceptual framework. Antimicrobial Stewardship & Healthcare Epidemiology : ASHE
|
|
2023;<strong>3</strong>(1):e9.
|
|
[<a href="/pmc/articles/PMC9879901/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9879901</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/36714285" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36714285</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – review of reviews.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Tonkin-Crine
|
|
SK, Tan
|
|
PS, van Hecke
|
|
O, Wang
|
|
K, Roberts
|
|
NW, McCullough
|
|
A, et al. Clinician-targeted interventions to influence antibiotic prescribing behaviour for acute respiratory infections in primary care: an overview of systematic reviews. Cochrane Database Syst Rev. 2017;<strong>9</strong>:CD012252.
|
|
[<a href="/pmc/articles/PMC6483738/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6483738</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28881002" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28881002</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population – includes mixed age population; adult subgroup analysis was planned but data were not available.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
van der Meer
|
|
V, Neven
|
|
AK, van den Broek
|
|
PJ, Assendelft
|
|
WJ. Diagnostic value of C reactive protein in infections of the lower respiratory tract: systematic review. BMJ. 2005;<strong>331</strong>(7507):26.
|
|
[<a href="/pmc/articles/PMC558535/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC558535</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/15979984" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15979984</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – no relevant outcomes reported (diagnostic accuracy data only).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
van der Velden
|
|
AW, Pijpers
|
|
EJ, Kuyvenhoven
|
|
MM, Tonkin-Crine
|
|
SK, Little
|
|
P, Verheij
|
|
TJ. Effectiveness of physician-targeted interventions to improve antibiotic use for respiratory tract infections. The British journal of general practice : the journal of the Royal College of General Practitioners. 2012;<strong>62</strong>(605):e801–7.
|
|
[<a href="/pmc/articles/PMC3505412/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3505412</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/23211259" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23211259</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention – not POC tests (interventions aimed at physicians).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Verbakel
|
|
JY, Lee
|
|
JJ, Goyder
|
|
C, Tan
|
|
PS, Ananthakumar
|
|
T, Turner
|
|
PJ, et al. Impact of point-of-care C reactive protein in ambulatory care: a systematic review and meta-analysis. BMJ Open
|
|
2019;<strong>9</strong>:e025036. [<a href="/pmc/articles/PMC6361331/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6361331</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30782747" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30782747</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes - relevant studies not synthesised quantitatively.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Vos
|
|
LM, Bruning
|
|
AHL, Reitsma
|
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JB, Schuurman
|
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R, Riezebos-Brilman
|
|
A, Hoepelman
|
|
AIM, et al. Rapid Molecular Tests for Influenza, Respiratory Syncytial Virus, and Other Respiratory Viruses: A Systematic Review of Diagnostic Accuracy and Clinical Impact Studies. Clin Infect Dis. 2019;<strong>69</strong>(7):1243–53.
|
|
[<a href="/pmc/articles/PMC7108200/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7108200</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30689772" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30689772</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – outcomes not reported separately in relevant impact studies (includes mixed study designs, mixed age population and settings).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Weber
|
|
NC, Klepser
|
|
ME, Akers
|
|
JM, Klepser
|
|
DG, Adams
|
|
AJ. Use of CLIA-waived point-of-care tests for infectious diseases in community pharmacies in the United States. Expert Rev Mol Diagn. 2016;<strong>16</strong>(2):253–64.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/26560318" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26560318</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – not a systematic review.</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Xie
|
|
X, Sinclair
|
|
A, Dendukuri
|
|
N. Evaluating the accuracy and economic value of a new test in the absence of a perfect reference test. Res. 2017;<strong>8</strong>(3):321–32. [<a href="https://pubmed.ncbi.nlm.nih.gov/28544646" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28544646</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – no relevant outcomes reported (diagnostic accuracy data only).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Xie
|
|
LM, Yin
|
|
X, Xie
|
|
TA, Su
|
|
JW, Huang
|
|
Q, Zhang
|
|
JH, et al. Meta-Analysis of the Diagnostic Efficacy of the Luminex xTAG Respiratory Viral Panel FAST v2 Assay for Respiratory Viral Infections. Yonsei Medical Journal
|
|
2022;<strong>63</strong>(1): 95–103.
|
|
[<a href="/pmc/articles/PMC8688366/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8688366</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/34913289" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34913289</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – no relevant outcomes reported (diagnostic accuracy data only).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Yasuo
|
|
S, Murata
|
|
M, Nakagawa
|
|
N, Kawasaki
|
|
T, Yoshida
|
|
T, Ando
|
|
K, et al. Diagnostic accuracy of urinary antigen tests for pneumococcal pneumonia among patients with acute respiratory failure suspected pneumonia: a systematic review and meta-analysis. BMJ Open
|
|
2022;<strong>12</strong>(8): e057216. [<a href="/pmc/articles/PMC9379505/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9379505</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/35953247" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35953247</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – no relevant outcomes reported (diagnostic accuracy data only).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Yoon
|
|
SH, Min
|
|
IK, Ahn
|
|
JG. Immunochromatography for the diagnosis of Mycoplasma pneumoniae infection: A systematic review and meta-analysis. PLoS ONE. 2020;<strong>15</strong>(3):e0230338.
|
|
[<a href="/pmc/articles/PMC7077834/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7077834</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32182283" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32182283</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – no relevant outcomes reported (diagnostic accuracy data only).</td></tr><tr><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Zhang
|
|
K, Xie
|
|
K, Zhang
|
|
C, Liang
|
|
Y, Chen
|
|
Z, Wang
|
|
H. C-reactive protein testing to reduce antibiotic prescribing for acute respiratory infections in adults: a systematic review and meta-analysis. Journal of Thoracic Disease
|
|
2022;<strong>14</strong>(1): p. 123–134.
|
|
[<a href="/pmc/articles/PMC8828529/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8828529</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/35242374" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35242374</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app4.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes - relevant studies not synthesised quantitatively.</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobniceng237er2app7tab1"><div id="niceng237er2.app7.tab1" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK598986/table/niceng237er2.app7.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__niceng237er2.app7.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Full reference</th><th id="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Reason for exclusion</th></tr></thead><tbody><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ameyaw
|
|
E, Nguah
|
|
SB, Ansong
|
|
D, Page
|
|
I, Guillerm
|
|
M, Bates
|
|
I. The outcome of a test-treat package versus routine outpatient care for Ghanaian children with fever: a pragmatic randomized control trial. Malaria Journal
|
|
2014;<strong>13</strong>:461. [DOI:10.1186/1475-2875-13-461]
|
|
|
|
[<a href="/pmc/articles/PMC4259007/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4259007</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25428264" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25428264</span></a>] [<a href="http://dx.crossref.org/10.1186/1475-2875-13-461" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population - children under 16 years.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Andrade
|
|
A, Bang
|
|
H, Reddick
|
|
K, Villaseñor
|
|
B, Tran
|
|
NK, May
|
|
L. Evaluation of pharmacist guided intervention using procalcitonin and respiratory virus testing. The American journal of emergency medicine
|
|
2023;<strong>66</strong>:146–151. 10.1016/j.ajem.2023.01.041
|
|
[<a href="/pmc/articles/PMC10038929/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC10038929</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/36773457" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36773457</span></a>] [<a href="http://dx.crossref.org/10.1016/j.ajem.2023.01.041" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention - unclear turnaround time for POCT and appears to be undertaken in a laboratory. Relevant outcome data for adult subgroup reported as <i>post hoc</i> analysis.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Andrews
|
|
D, Chetty
|
|
Y, Cooper
|
|
BS, Virk
|
|
M, Glass
|
|
SK, Letters
|
|
A, et al. Multiplex PCR point of care testing versus routine, laboratory-based testing in the treatment of adults with respiratory tract infections: a quasi-randomised study assessing impact on length of stay and antimicrobial use. BMC Infect Dis
|
|
2017;<strong>17</strong>:1–11.
|
|
[<a href="/pmc/articles/PMC5635493/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5635493</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29017451" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29017451</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – not an RCT (‘quasi-randomised’ study). Includes adult inpatients and outpatients - only reporting the number of patients discharged without admission separately in outpatients. Unclear if comparator is ‘usual care’.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Bjerrum
|
|
L, Cots
|
|
JM, Llor
|
|
C, Molist
|
|
N, Munck
|
|
A. Effect of intervention promoting a reduction in antibiotic prescribing by improvement of diagnostic procedures: a prospective, before and after study in general practice. Eur J Clin Pharmacol
|
|
2006;<strong>62</strong>:913–8.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/16967300" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16967300</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – not an RCT (before-after study/audit). Unclear population age.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Boere
|
|
TM, Hopstaken
|
|
RM, van Tulder
|
|
MW, Schellevis
|
|
FG, Verheij
|
|
TJM, Hertogh
|
|
Cmpm, et al. Implementation and Use of Point-of-Care C-Reactive Protein Testing in Nursing Homes. Journal of the American Medical Directors Association
|
|
2022;<strong>23</strong>(6):968–975.e3.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/34626578" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34626578</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes - qualitative outcome data only.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Boere
|
|
TM, van Buul
|
|
LW, Hopstaken
|
|
RM, Veenhuizen
|
|
RB, van Tulder
|
|
MW, Cals
|
|
JWL, et al. Using point-of-care C-reactive protein to guide antibiotic prescribing for lower respiratory tract infections in elderly nursing home residents (UPCARE): study design of a cluster randomized controlled trial. BMC health services research
|
|
2020;<strong>20</strong>(1):149. 10.1186/s12913-020-5006-0
|
|
[<a href="/pmc/articles/PMC7045632/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7045632</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32103747" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32103747</span></a>] [<a href="http://dx.crossref.org/10.1186/s12913-020-5006-0" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication type - conference abstract only and no results reported.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Bouzid
|
|
D, Casalino
|
|
E, Mullaert
|
|
J, Laurent
|
|
O, Duval
|
|
X, Lescure
|
|
FX, et al. Added value of rapid respiratory syndromic testing at point of care versus central laboratory testing: a controlled clinical trial. J Antimicrob Chemother
|
|
2021;<strong>76</strong>
|
|
suppl 3:iii20–iii27.
|
|
[<a href="/pmc/articles/PMC8460108/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8460108</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/34555158" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34555158</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – not an RCT (retrospective observational study). POCT and results turnaround time >45 minutes.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Brendish
|
|
NJ, Malachira
|
|
A K, Armstrong
|
|
L, Houghton
|
|
R, Aitken
|
|
S, Nyimbili, E, et al. Routine molecular point-of-care testing for respiratory viruses in adults presenting to hospital with acute respiratory illness (ResPOC): a pragmatic, open-label, randomised controlled trial. Lancet Respir Med
|
|
2017;<strong>5</strong>:401–11.
|
|
[<a href="/pmc/articles/PMC7164815/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7164815</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28392237" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28392237</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population – includes patients at initial contact (ED) and patients after initial contact (i.e. secondary contact - acute medical unit); outcome data not reported separately for relevant population (i.e. initial contact).</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Brendish
|
|
NJ, Malachira
|
|
AK, Beard
|
|
KR, Ewings
|
|
S, Clark
|
|
TW. Impact of turnaround time on outcome with point-of-care testing for respiratory viruses: a post hoc analysis from a randomised controlled trial. The European respiratory journal
|
|
2018;<strong>52</strong>(2):1800555.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/29946003" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29946003</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population – includes patients at initial contact (ED) and patients after initial contact (i.e. secondary contact - acute medical unit); outcome data not reported separately for relevant population (i.e. initial contact).</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Briel
|
|
M, Schuetz
|
|
P, Mueller
|
|
B, Young
|
|
J, Schild
|
|
U, Nusbaumer
|
|
C, et al. Procalcitonin-guided antibiotic use vs a standard approach for acute respiratory tract infections in primary care. Arch Intern Med
|
|
2008;<strong>168</strong>:2000–7.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/18852401" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18852401</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention - not a POCT (laboratory test) and results turnaround time >45 minutes.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Burkhardt
|
|
O, Ewig
|
|
S, Haagen
|
|
U, Giersdorf
|
|
S, Hartmann
|
|
O, Wegscheider
|
|
K, et al. Procalcitonin guidance and reduction of antibiotic use in acute respiratory tract infection. Eur Respir J
|
|
2010
|
|
Sep;<strong>36</strong>(3):601–7.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/20185423" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20185423</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention – not a POCT and results turnaround time ≤4 h.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Busson
|
|
L, Mahadeb
|
|
B, De Foor
|
|
M, Vandenberg
|
|
O, Hallin
|
|
M. Contribution of a rapid influenza diagnostic test to manage hospitalized patients with suspected influenza. Diagn Micro-biol Infect Dis
|
|
2017;<strong>87</strong>:238–42. [<a href="https://pubmed.ncbi.nlm.nih.gov/27939284" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27939284</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design - not an RCT (diagnostic accuracy data).</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Cals
|
|
JW, Ament
|
|
AJ, Hood
|
|
K, Butler
|
|
CC, Hopstaken
|
|
RM, Wassink
|
|
GF, et al. C-reactive protein point of care testing and physician communication skills training for lower respiratory tract infections in general practice: economic evaluation of a cluster randomized trial. J Eval Clin Pract
|
|
2010;<strong>17</strong>:1059–69.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/20666881" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20666881</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – not an RCT (economic evaluation).</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Cals
|
|
J, Butler
|
|
C, Hopstaken
|
|
R, Hood
|
|
K, Dinant
|
|
GJ. Effect of C-reactive protein point of care testing and clinical communication skills training on antibiotic use and patient recovery in lower respiratory tract infections: a cluster randomised trial. European respiratory society annual congress, Berlin, Germany, October 4-8, 2008:[P3500].
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication type – conference abstract only.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Carter
|
|
JA, Burke
|
|
HB. CRP-Guided Antibiotic Therapy for Acute COPD Exacerbation: a Randomized Control Trial. Journal of general internal medicine
|
|
2021;<strong>36</strong>(7):2194–2196.
|
|
[<a href="/pmc/articles/PMC8298731/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8298731</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/33948805" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33948805</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population – unclear population age; unclear results turnaround time for POCT.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Christ-Crain
|
|
M, Jaccard-Stolz
|
|
D, Bingisser
|
|
R, Gencay
|
|
M, Huber
|
|
P, Tamm
|
|
M, et al. Effect of procalcitonin-guided treatment on antibiotic use and outcome in lower respiratory tract infections: cluster-randomised, single-blinded intervention trial. Lancet (London, England)
|
|
2004;<strong>363</strong>:600–7.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/14987884" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 14987884</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention - turnaround time for results >45 mins.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Christ-Crain
|
|
M, Stolz
|
|
D, Bingisser
|
|
R, Muller
|
|
C, Miedinger
|
|
D, Huber
|
|
P, et al. Procalcitonin guidance of antibiotic therapy in community-acquired pneumonia: a randomized trial. Am J Respir Crit Care Med
|
|
2006;<strong>174</strong>:84–93.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/16603606" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16603606</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention – not a POCT (laboratory test).</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Clark
|
|
TW, Beard
|
|
KR, Brendish
|
|
NJ, Malachira
|
|
AK, Mills
|
|
S, Chan
|
|
C, et al. Clinical impact of a routine, molecular, point-of-care, test-and-treat strategy for influenza in adults admitted to hospital (FluPOC): a multicentre, open-label, randomised controlled trial. Lancet respiratory medicine
|
|
2021;<strong>9</strong>(4):419–429.
|
|
[<a href="/pmc/articles/PMC9764870/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9764870</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/33285143" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33285143</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population – includes patients at initial contact (ED) and patients after initial contact (i.e. secondary contact - acute medical unit); outcome data not reported separately for relevant population (i.e. initial contact).</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Clark
|
|
TW, Mills
|
|
S, Brendish
|
|
N. The impact of syndromic molecular point-of-care testing for respiratory viruses on antibiotic use in adults presenting to hospital with exacerbation of airways disease: further analysis from a randomized controlled trial. Open forum infectious diseases
|
|
2019;<strong>6</strong>:S988.
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication type - conference abstract only. Not an RCT and compares patients testing positive versus negative for viruses versus controls</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Diederichsen
|
|
HZ, Skamling
|
|
M, Diederichsen
|
|
A, Grinsted
|
|
P, Antonsen
|
|
S, Petersen
|
|
PH, et al. A randomized controlled trial of the use of CRP rapid test as a guide to treatment of respiratory infections in general practice. Ugeskrift for laeger
|
|
2001;<strong>163</strong>(27): 3784–3787.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/11466986" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11466986</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Language – non-English.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Drks, Influence of a guideline and an additional rapid test for group A Streptococci on antibiotic prescriptions for patients presenting with sore throat in primary care. <a href="https://trialsearch.who.int/Trial2.aspx?TrialID=DRKS00013018" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://trialsearch<wbr style="display:inline-block"></wbr>​.who<wbr style="display:inline-block"></wbr>​.int/Trial2.aspx?TrialID=DRKS00013018</a>, 2017.
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – clinical trial website; no results posted.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Echavarría
|
|
M, Marcone
|
|
DN, Querci
|
|
M, Seoane
|
|
A, Ypas
|
|
M, Videla
|
|
C, et al. Clinical impact of rapid molecular detection of respiratory pathogens in patients with acute respiratory infection. J Clin Virol
|
|
2018;<strong>108</strong>:90–5.
|
|
[<a href="/pmc/articles/PMC7172208/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7172208</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30267999" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30267999</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention – not a POCT (laboratory test); results turnaround time approximately 65 minutes.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Eley
|
|
CV, Sharma
|
|
A, Lee
|
|
H, Charlett
|
|
A, Owens
|
|
R, McNulty
|
|
CAM. Effects of primary care C-reactive protein point-of-care testing on antibiotic prescribing by general practice staff: pragmatic randomised controlled trial, England, 2016 and 2017. Euro surveillance
|
|
2020;<strong>25</strong>(44):1900408.
|
|
[<a href="/pmc/articles/PMC7645970/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7645970</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/33153517" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33153517</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention – practices in the intervention arm used a diagnostic score to decide whether a CRP test was needed; only one third of the intervention arm received a POCT.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Fally
|
|
M, Corti
|
|
C, Fabricius-Bjerre
|
|
A, Mortensen
|
|
K, Jensen
|
|
BN, Andreassen
|
|
H. Point-of-care procalcitonin test to reduce antibiotics in COPD exacerbation: a quasi-randomised control trial. European respiratory journal
|
|
2015;<strong>46</strong>:OA4752.
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population - patients hospitalised with COPD exacerbation. Unclear turnaround time for POCT results. Conference abstract only.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Fawsitt
|
|
C, Lucey
|
|
D, Harrington
|
|
P, Jordan
|
|
K, Marshall
|
|
L, O’Brien
|
|
KK, Teljeur
|
|
C. A cost-effectiveness and budget impact analysis of C-reactive protein point-of-care testing to guide antibiotic prescribing for acute respiratory tract infections in primary care settings in Ireland: a decision-analytic model. Family Practice
|
|
2022;<strong>39</strong>:389–97.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/34591966" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34591966</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design - not an RCT; cost-effectiveness data sourced from an NMA of 7 RCTs.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Gelfer
|
|
G, Leggett
|
|
J, Myers
|
|
J, Wang
|
|
L, Gilbert
|
|
DN. The clinical impact of the detection of potential etiologic pathogens of community-acquired pneumonia. Diagn Microbiol Infect Dis
|
|
2015;<strong>83</strong>:400–6.
|
|
[<a href="/pmc/articles/PMC7125660/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7125660</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26341706" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26341706</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention – results turnaround time >45 minutes.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Gilbert
|
|
D, Gelfer
|
|
G, Wang
|
|
L, Myers
|
|
J, Bajema
|
|
K, Johnston
|
|
M, et al. The potential of molecular diagnostics and serum procalcitonin levels to change the antibiotic management of community-acquired pneumonia. Diagn Microbiol Infect Dis
|
|
2016;<strong>86</strong>:102–7.
|
|
[<a href="/pmc/articles/PMC7126930/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7126930</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27377675" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27377675</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention – results turnaround time >45 minutes.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Gomez
|
|
S, Prieto
|
|
C, Folgueira
|
|
L. A prospective study to assess the diagnostic performance of the Sofia((R)) Immunoassay for Influenza and RSV detection. J Clin Virol
|
|
2016;<strong>77</strong>:1–4.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/26872325" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26872325</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population - includes hospitalised patients of mixed ages (adults and children). Diagnostic accuracy study.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Gonzales
|
|
R, Aagaard
|
|
EM, Camargo
|
|
CA
|
|
Jr, Ma
|
|
OJ, Plautz
|
|
M, Maselli
|
|
JH, et al. C-reactive protein testing does not decrease antibiotic use for acute cough illness when compared to a clinical algorithm. J Emerg Med
|
|
2011;<strong>41</strong>(1):1–7.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/19095403" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19095403</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparator - not usual care; both intervention and comparator groups had a detailed clinical algorithm placed in their medical chart.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Gonzales
|
|
R, Anderer
|
|
T, McCulloch
|
|
CE, Maselli
|
|
JH, Bloom
|
|
FJ, Graf
|
|
TR, et al. A cluster-randomized trial of decision support strategies for reducing antibiotic use for acute bronchitis. JAMA Intern Med
|
|
2013;<strong>173</strong>:267–73.
|
|
[<a href="/pmc/articles/PMC3582762/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3582762</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/23319069" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23319069</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention - not a POCT (compares printed intervention versus computerised versus control).</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Hazelton
|
|
B, Gray
|
|
T, Ho
|
|
J, Ratnamohan
|
|
VM, Dwyer
|
|
DE, Kok
|
|
J. Detection of influenza A and B with the Alere i Influenza A & B: a novel isothermal nucleic acid amplification assay. Influ-enza Other Respir Viruses
|
|
2015;<strong>9</strong>:151–4. [<a href="/pmc/articles/PMC4415699/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4415699</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25728758" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25728758</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – not an RCT (diagnostic accuracy study).</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Hazelton
|
|
B, Nedeljkovic
|
|
G, Ratnamohan
|
|
VM, Dwyer
|
|
DE, Kok
|
|
J. Evaluation of the Sofia Influenza A + B fluorescent immuno-assay for the rapid diagnosis of influenza A and B. J Med Virol
|
|
2015;<strong>87</strong>:35–8.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/24838873" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24838873</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – not an RCT (diagnostic accuracy study).</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Holm
|
|
A, Nexoe
|
|
J, Bistrup
|
|
LA, Pedersen
|
|
SS, Obel
|
|
N, Nielsen
|
|
LP, Pedersen
|
|
C. Aetiology and prediction of pneumonia in lower respiratory tract infection in primary care. Br J Gen Pract
|
|
2007;<strong>57</strong>:547–554.
|
|
[<a href="/pmc/articles/PMC2099637/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2099637</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/17727747" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17727747</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design - not an RCT (observational study); not a POCT.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Holmes
|
|
EAF, Harris
|
|
SD, Hughes
|
|
A, Craine
|
|
N, Hughes
|
|
DA. Cost-Effectiveness Analysis of the Use of Point-of-Care C-Reactive Protein Testing to Reduce Antibiotic Prescribing in Primary Care. Antibiotics (Basel, Switzerland)
|
|
2018;<strong>7</strong>(4):106.
|
|
[<a href="/pmc/articles/PMC6315627/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6315627</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30544560" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30544560</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design - cost-effectiveness study based on non-RCT clinical data.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Huang
|
|
DT, Yealy
|
|
DM, Filbin
|
|
MR, Brown
|
|
AM, Chang
|
|
CH, Doi
|
|
Y, et al. Procalcitonin-guided use of antibiotics for lower respiratory tract infection. New England Journal of Medicine
|
|
2018;<strong>379</strong>(3):236–49. [DOI: 10.1056/NEJMoa1802670]
|
|
[<a href="/pmc/articles/PMC6197800/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6197800</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29781385" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29781385</span></a>] [<a href="http://dx.crossref.org/10.1056/NEJMoa1802670" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention - rapid assay test appears to be conducted in a laboratory.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Hunter
|
|
R. Cost-effectiveness of point-of-care C-reactive protein tests for respiratory tract infection in primary care in England. Advances in Therapy
|
|
2015;<strong>32</strong>(1):69–85.
|
|
[<a href="/pmc/articles/PMC4311066/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4311066</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25620538" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25620538</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design - cost-effectiveness study (clinical data based on Cals 2013 RCT).</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Isa
|
|
HM, Mohroofi
|
|
AD, Alkhan
|
|
FN, Hasan
|
|
AZ, Alkubis
|
|
MM, Alhewaizem
|
|
SS, et al. C-reactive protein levels in children with acute bronchiolitis. International Journal of Pediatrics
|
|
23
|
|
May
|
|
2022;eCollection:1311936. [DOI: 10.1155/2022/1311936] [<a href="/pmc/articles/PMC9152401/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9152401</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/35655792" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35655792</span></a>] [<a href="http://dx.crossref.org/10.1155/2022/1311936" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population – children under 16 years.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Isrctn, Molecular point-of-care ‘test and treat’ for influenza (FluPOC). <a href="https://trialsearch.who.int/Trial2.aspx?TrialID=ISRCTN17197293" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://trialsearch<wbr style="display:inline-block"></wbr>​.who<wbr style="display:inline-block"></wbr>​.int/Trial2.aspx?TrialID<wbr style="display:inline-block"></wbr>​=ISRCTN17197293</a>, 2017.
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population – protocol to Clark 2021; includes both patients at initial contact (ED) and secondary contact (acute medical unit); outcome data not reported separately for relevant population (i.e. initial contact).</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Jakobsen
|
|
KA, Melbye
|
|
H, Kelly
|
|
MJ, Ceynowa
|
|
C, Molstad
|
|
S, Hood
|
|
K, Butler
|
|
CC. Influence of CRP testing and clinical findings on antibiotic prescribing in adults presenting with acute cough in primary care. Scand J Prim Health Care
|
|
2010;<strong>28</strong>(4):229–36.
|
|
[<a href="/pmc/articles/PMC3444795/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3444795</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/20704523" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20704523</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design - not an RCT (observational data from practices in different countries).</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Jung
|
|
CY, Choe
|
|
YH, Lee
|
|
SY, Kim
|
|
WJ, Lee
|
|
JD, Ra
|
|
SW, et al. Use of serology and polymerase chain reaction to detect atypical respiratory pathogens during acute exacerbation of chronic obstructive pulmonary disease. The Korean journal of internal medicine
|
|
2018;<strong>33</strong>(5):941–951.
|
|
[<a href="/pmc/articles/PMC6129643/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6129643</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29929350" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29929350</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention - <i>post hoc</i> analysis of an RCT; assesses differences between patients with and without atypical respiratory pathogens; no relevant outcomes reported.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kaku
|
|
N, Urabe
|
|
T, Iida
|
|
T, Yun
|
|
C, Nishida
|
|
Y, Onitsuka
|
|
Y, et al., Gargle sample is an effective option in a novel fully automated molecular point-of-care test for influenza: a multicenter study. Virology Journal
|
|
2023;<strong>20</strong>(1):41.
|
|
[<a href="/pmc/articles/PMC9983540/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9983540</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/36869389" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36869389</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – not an RCT. Includes adults and children with outcomes not reported separately in adults.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Klepser
|
|
ME, Hagerman
|
|
J, Klepser
|
|
DG, Klepser
|
|
SA, Bergman
|
|
SJ. Evaluation of a community pharmacy-based influenza screening and management program versus pharmacy screening and referral to standard of care. Pharmacotherapy
|
|
2011;<strong>31</strong>(10):323e.
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication type – conference abstract only.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Kristoffersen
|
|
KB, Sogaard
|
|
OS, Wejse
|
|
C, Black
|
|
FT, Greve
|
|
T, Tarp
|
|
B, et al. Antibiotic treatment interruption of suspected lower respiratory tract infections based on a single procalcitonin measurement at hospital admission – a randomized trial. Clin Microbiol Infect
|
|
2009;<strong>15</strong>:481–7.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/19416298" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19416298</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention – not a POCT; test results were available on the following day, except for weekends.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Lee
|
|
CK, Cho
|
|
CH, Woo
|
|
MK, Nyeck
|
|
AE, Lim
|
|
CS, Kim
|
|
WJ. Evaluation of Sofia fluorescent immunoassay analyzer for influenza A/B virus. J Clin Virol
|
|
2012;<strong>55</strong>:239–43.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/22871494" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22871494</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – not an RCT (diagnostic accuracy study).</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Leonardi
|
|
GP, Wilson
|
|
AM, Zuretti
|
|
AR. Comparison of conven-tional lateral-flow assays and a new fluorescent immunoas-say to detect influenza viruses. J Virol Methods
|
|
2013;<strong>189</strong>:379–82.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/23458693" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23458693</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – not an RCT (diagnostic accuracy study).</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Lewandrowski
|
|
K, Tamerius
|
|
J, Menegus
|
|
M, Olivo
|
|
PD, Lollar
|
|
R, Lee-Lewandrowski
|
|
E. Detection of influenza A and B viruses with the Sofia analyzer: a novel, rapid immunofluorescence-based in vitro diagnostic device. Am J Clin Pathol
|
|
2013;<strong>139</strong>: 684–9.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/23596120" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23596120</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes - diagnostic accuracy study; not a POCT (laboratory test). Includes mixed age population.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Limper
|
|
M, van der Does
|
|
Y, Brandjes
|
|
DP, De Kruif
|
|
MD, Rood
|
|
PP, van Gorp
|
|
EC. Procalcitonin guided antibiotic therapy in patients presenting with fever in the emergency department. Journal of infection
|
|
2014;<strong>69</strong>(4):410–412.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/24820656" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24820656</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – letter.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Little
|
|
P, Hobbs
|
|
FDR, Moore
|
|
M, Mant
|
|
D, Williamson
|
|
I, McNulty
|
|
C, et al. Clinical score and rapid antigen detection test to guide antibiotic use for sore throats: randomised controlled trial of PRISM (primary care streptococcal management). BMJ
|
|
2013;<strong>347</strong>:f5806.
|
|
[<a href="/pmc/articles/PMC3805475/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3805475</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24114306" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24114306</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population – includes adults and children; outcomes not reported separately in adults.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Little
|
|
P, Hobbs
|
|
R, Moore
|
|
M, Mant
|
|
D, Williamson
|
|
I. PRImary Care Streptococcal Management Study (PRISM): in vitro study, diagnostic cohorts, and a pragmatic adaptive randomised controlled trial with nested qualitative study and cost-effectiveness study. Health Technology Assessment
|
|
2014;<strong>18</strong>(6):1–101. [DOI: 10.3310/hta18060] [<a href="/pmc/articles/PMC4781545/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4781545</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24467988" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24467988</span></a>] [<a href="http://dx.crossref.org/10.3310/hta18060" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population - in vitro study, diagnostic cohorts and RCT which includes a mixed age population; outcomes not reported separately in adults.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Llor
|
|
C, Bjerrum
|
|
L, Munck
|
|
A, Cots
|
|
JM, Hernández
|
|
S, Moragas
|
|
A. Access to point-of-care tests reduces the prescription of antibiotics among antibiotic-requesting subjects with respiratory tract infections. Respiratory Care
|
|
2014;<strong>59</strong>:1918–23.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/25468986" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25468986</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population - age of patients not specified (appears to be any age). Not an RCT (before-after study). No relevant comparator.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Llor
|
|
C, Cots
|
|
JM, Gonzalez Lopez-Valcarcel
|
|
B, de Dios Alcantara
|
|
J, Garcia
|
|
G, Arranz
|
|
J, et al. Effect of two interventions on reducing antibiotic prescription in pharyngitis in primary care. Journal of Antimicrobial Chemotherapy
|
|
2011;<strong>66</strong>:210–5.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/21081543" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21081543</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – not an RCT (before-after study). No relevant comparator.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Llor
|
|
C, Sierra
|
|
N, Hernandez
|
|
S
|
|
et al. Impact of C-reactive protein testing on adherence to thrice-daily antibiotic regimens in patients with lower respiratory tract infection. Prim Care Respir J
|
|
2010;<strong>19</strong>:358–62.
|
|
[<a href="/pmc/articles/PMC6602257/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6602257</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/20464350" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20464350</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – not an RCT (before-after study).</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Long
|
|
W, Deng
|
|
X, Zhang
|
|
Y, Lu
|
|
G, Xie
|
|
J, Tang
|
|
J. Procalcitonin guidance for reduction of antibiotic use in low-risk outpatients with community-acquired pneumonia. Respirology (Carlton, Vic.)
|
|
2011;<strong>16</strong>(5):819–824.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/21507143" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21507143</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population - some included patients had been in the ED observation unit for up to 24 hours. Test ‘measured within 1 hour’.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Lubell
|
|
Y, Do
|
|
NTT, Nguyen
|
|
KV, Ta
|
|
NTD, Tran
|
|
NTH, Than
|
|
HM, et al. C-reactive protein point of care testing in the management of acute respiratory infections in the Vietnamese primary healthcare setting - a cost benefit analysis. Antimicrob Resist Infect Control
|
|
2018;<strong>7</strong>:119.
|
|
[<a href="/pmc/articles/PMC6172744/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6172744</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30323922" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30323922</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – cost-benefit study.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Madurell
|
|
J, Balague
|
|
M, Gomez
|
|
M, Cots
|
|
JM, Llor
|
|
C. Impact of rapid antigen detection testing on antibiotic prescription in acute pharyngitis in adults. FARINGOCAT STUDY: a multicentric randomized controlled trial. BMC Family Practice
|
|
2010;<strong>11</strong>:25.
|
|
[<a href="/pmc/articles/PMC2859488/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2859488</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/20331895" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20331895</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – protocol only; no outcomes reported.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
May
|
|
L, Tatro
|
|
G, Poltavskiy
|
|
E, Mooso
|
|
B, Hon
|
|
S, Bang
|
|
H, et al. Rapid multiplex testing for upper respiratory pathogens in the emergency department: a randomized controlled trial. Open forum infectious diseases
|
|
2019;<strong>6</strong>(12):ofz481.
|
|
[<a href="/pmc/articles/PMC7043218/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7043218</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32128326" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32128326</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention – not a POCT (onsite laboratory test).</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Montassier
|
|
E, Javaudin
|
|
F, Moustafa
|
|
F, Nandjou
|
|
D, Maignan
|
|
M, Hardouin
|
|
JB, et al. Guideline-based clinical assessment versus procalcitonin-guided antibiotic use in pneumonia: a pragmatic randomized trial. Annals of Emergency Medicine
|
|
2019;<strong>74</strong>(4):580–91.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/30982631" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30982631</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention – not a POCT (onsite laboratory test).</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Na, J.O., et al., Detection of atypical respiratory pathogens in acute exacerbations of chronic obstructive pulmonary disease by serology and PCR. American journal of respiratory and critical care medicine, 2015. 191(no pagination).
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication type – conference abstract only.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nct, Rapid Diagnostics for Upper Respiratory Infections in the Emergency Department. <a href="https://clinicaltrials.gov/show/NCT02957136" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://clinicaltrials.gov/show/NCT02957136</a>, 2016.
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention – not a POCT (onsite laboratory test). Linked to May 2019.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nct, Stratified TreAtment to Reduce Risk in COPD. <a href="https://clinicaltrials.gov/show/NCT04458636" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://clinicaltrials.gov/show/NCT04458636</a>, 2020.
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – trial record with no results posted.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
NCT03744832. Point of care streptococcal pharyngitis testing. <a href="http://clinicaltrials.gov/ct2/show/NCT03744832" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinicaltrials.gov/ct2/show/NCT03744832</a>.
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population – children under 16 years. Trial record with no results posted.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Nicholson
|
|
KG, Abrams
|
|
KR, Batham
|
|
S, Medina
|
|
MJ, Warren
|
|
FC, Barer
|
|
M, et al. Randomised controlled trial and health economic evaluation of the impact of diagnostic testing for influenza, respiratory syncytial virus and Streptococcus pneumoniae infection on the management of acute admissions in the elderly and high-risk 18-to 64-year-olds. Health Technol Assess. 2014;<strong>18</strong>:1–viii. [<a href="/pmc/articles/PMC4781605/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4781605</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24875092" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24875092</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population – inpatients.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Noh
|
|
JY, Choi
|
|
WS, Lee
|
|
J, Kim
|
|
HL, Song
|
|
JY, Cheong
|
|
HJ, et al. Clinical performance of the Sofia Influenza A+B FIA in adult patients with influenza-like illness. Diagn Microbiol Infect Dis
|
|
2015;<strong>83</strong>:130–2.
|
|
[<a href="/pmc/articles/PMC7127480/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7127480</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26184128" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26184128</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparator - not usual care. Diagnostic accuracy study.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ntr, Bedside testing for lower respiratory tract infections in nursing homes. <a href="https://trialsearch.who.int/Trial2.aspx?TrialID=NTR7452" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://trialsearch<wbr style="display:inline-block"></wbr>​.who<wbr style="display:inline-block"></wbr>​.int/Trial2.aspx?TrialID=NTR7452</a>, 2018.
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – trial record with no results posted.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Onwunduba
|
|
A, Ekwunife
|
|
O, Onyilogwu
|
|
E. Impact of point-of-care c-reactive protein testing intervention on non-prescription dispensing of antibiotics for respiratory tract infections in private community pharmacies in Nigeria: a cluster randomized controlled trial. International journal of infectious diseases
|
|
2023;<strong>127</strong>:137–143.
|
|
[<a href="/pmc/articles/PMC9876806/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9876806</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/36509332" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36509332</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population – simulated patients.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Oosterheert
|
|
JJ, van Loon
|
|
AM, Schuurman
|
|
R, Hoepelman
|
|
AI, Hak
|
|
E, Thijsen
|
|
S, et al. Impact of rapid detection of viral and atypical bacterial pathogens by real-time polymerase chain reaction for patients with lower respiratory tract infection. Clinical infectious diseases
|
|
2005;<strong>41</strong>(10):1438–1444.
|
|
[<a href="/pmc/articles/PMC7107964/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7107964</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/16231254" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16231254</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population – inpatients. Not near patient test and results within 48 hours.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Oppong
|
|
R, Jit
|
|
M, Smith
|
|
RD, Butler
|
|
CC, Melbye
|
|
H, Mölstad
|
|
S, et al. Cost-effectiveness of point-of-care C-reactive protein testing to inform antibiotic prescribing decisions. Br J Gen Pract
|
|
2013; <strong>63</strong>(612):e465–e471.
|
|
[<a href="/pmc/articles/PMC3693803/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3693803</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/23834883" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23834883</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – not an RCT (observational data).</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Orda
|
|
U, Mitra
|
|
B, Orda
|
|
S, Fitzgerald
|
|
M, Gunnarsson
|
|
R, Rofe
|
|
G, et al. Point of care testing for group A streptococci in patients presenting with pharyngitis will improve appropriate antibiotic prescription. Emergency Medicine Australasia
|
|
2016;<strong>28</strong>:199–204.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/26934845" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26934845</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population – children under 16 years. Not an RCT.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Papastergiou
|
|
J, Trieu
|
|
CR, Saltmarche
|
|
D, Diamantouros
|
|
A. Community pharmacist-directed point-of-care group A Streptococcus testing: evaluation of a Canadian program. Journal of the American Pharmacists Association
|
|
2018;<strong>58</strong>:450–6.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/29681440" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29681440</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – not an RCT (retrospective analysis of aggregate billing data).</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ramakrishnan
|
|
S, Jeffers
|
|
H, Langford-Wiley
|
|
B, Davies
|
|
J, Mahdi
|
|
M. A’Court
|
|
C. et al. Point of care blood eosinophil guided oral prednisolone for COPD exacerbations: a multicentre double blind randomised controlled trial (The STARR2 trial). Thorax
|
|
2022;<strong>77</strong>:A3–A4. [<a href="https://pubmed.ncbi.nlm.nih.gov/37924830" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 37924830</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication type – conference abstract only.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ramakrishnan
|
|
S, Jeffers
|
|
H, Langford-Wiley
|
|
B, Davies
|
|
J, Mahdi
|
|
M. A’Court
|
|
C. et al. Point of care blood eosinophil guided oral prednisolone for COPD exacerbations: a multi-centre double blind randomised controlled trial(The STARR2 trial). European respiratory journal, 2022. 60. [<a href="https://pubmed.ncbi.nlm.nih.gov/37924830" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 37924830</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication type – conference abstract only.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Rogers
|
|
JH, Casto
|
|
AM, Nwanne
|
|
G, Link
|
|
AC, Martinez
|
|
MA, Nackviseth
|
|
C, et al. Results from a test-and-treat study for influenza among residents of homeless shelters in King County, WA: a stepped-wedge cluster-randomized trial. Influenza and other respiratory viruses
|
|
2023;<strong>17</strong>(1):e13092.
|
|
[<a href="/pmc/articles/PMC9835442/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9835442</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/36610058" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36610058</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population – includes adults and children; outcomes not reported separately in adults.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ryu
|
|
SW, Lee
|
|
JH, Kim
|
|
J, Jang
|
|
MA, Nam
|
|
JH, Byoun
|
|
MS, et al. Comparison of two new generation influenza rapid diagnostic tests with instrument-based digital readout systems for influenza virus detection. Br J Biomed Sci
|
|
2016;<strong>73</strong>:115–20.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/27327199" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27327199</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparator – not usual care. Diagnostic accuracy study.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Ryu
|
|
SW, Suh
|
|
IB, Ryu
|
|
SM, Shin
|
|
KS, Kim
|
|
HS, Kim
|
|
J, et al. Comparison of three rapid influenza diagnostic tests with digital readout systems and one conventional rapid influenza diagnostic test. J Clin Lab Anal
|
|
2018;<strong>32</strong>:e22234.
|
|
[<a href="/pmc/articles/PMC6817280/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6817280</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/28407318" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28407318</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparator – not usual care. Diagnostic accuracy study.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Schechter-Perkins
|
|
EM, Mitchell
|
|
PM, Nelson
|
|
KP, Liu
|
|
JH, Shannon
|
|
A, Ahern
|
|
J, et al. Point-of-care influenza testing does not significantly shorten time to disposition among patients with an influenza-like illness. American Journal of Emergency Medicine
|
|
2019;<strong>37</strong>(5):873–8. [DOI: 10.1016/j.ajem.2018.08.005.]
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/30107967" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30107967</span></a>] [<a href="http://dx.crossref.org/10.1016/j.ajem.2018.08.005" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population - mixed age population; outcomes not reported separately in adults. Influenza POCT versus core laboratory testing.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Schechter-Perkins
|
|
EM, et al. Point-of-care influenza testing does not significantly shorten time to disposition among emergency department patients with an influenza-like illness. Annals of emergency medicine
|
|
2017;<strong>70</strong>(4):S61. [<a href="https://pubmed.ncbi.nlm.nih.gov/30107967" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30107967</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication type – conference abstract only.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Schot
|
|
MJ, Van den Bruel
|
|
A, Broekhuizen
|
|
BD, Cals
|
|
JW, Noteboom
|
|
EA, Balemans
|
|
W, et al. Point-of-care C-reactive protein to assist in primary care management of children with suspected non-serious lower respiratory tract infection: a randomised controlled trial. BJGP Open
|
|
2018;<strong>2</strong>(3):1–10. [DOI: 10.3399/bjgpopen18X101600] [<a href="/pmc/articles/PMC6189779/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6189779</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30564733" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30564733</span></a>] [<a href="http://dx.crossref.org/10.3399/bjgpopen18X101600" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">CrossRef</a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population – children under 16 years.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Schuetz
|
|
P, Christ-Crain
|
|
M, Thomann
|
|
R, Falconnier
|
|
C, Wolbers
|
|
M, Widmer
|
|
I, et al. Effect of procalcitonin-based guidelines vs standard guidelines on antibiotic use in lower respiratory tract infections: the ProHOSP randomized controlled trial. JAMA
|
|
2009;<strong>302</strong>:1059–66.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/19738090" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19738090</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention – not near patient test (central laboratory test).</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Schuetz
|
|
P, Christ-Crain
|
|
M, Thomann
|
|
R, Falconnier
|
|
C. Effect of procalcitonin-based guidelines compared with standard guidelines on antibiotic use in lower respiratory tract infections: the randomized-controlled multicenter ProHOSP trial. Critical care (London, England)
|
|
2009;<strong>13</strong>
|
|
Suppl:1P386 (Abstract number).
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication type – conference abstract only.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Schuetz
|
|
P, Christ-Crain
|
|
M, Wolbers
|
|
M, Schild
|
|
U, Thomann
|
|
R, Falconnier
|
|
C, et al. Procalcitonin guided antibiotic therapy and hospitalization in patients with lower respiratory tract infections: a prospective, multicenter, randomized controlled trial. BMC health services research
|
|
2007;<strong>7</strong>:102.
|
|
[<a href="/pmc/articles/PMC1947969/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1947969</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/17615073" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17615073</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes – protocol only; no outcomes reported.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Schuetz
|
|
P, Grolimund
|
|
E, Kutz
|
|
A, Haubitz
|
|
S, Mueller
|
|
B, et al. Procalcitonin-guided antibiotic therapy in patients with congestive heart failure and suspicion of lower respiratory tract infection: results from a randomized trial. Critical care (London, England)
|
|
2013;<strong>17</strong>:S12.
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication type – conference abstract only.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Selove
|
|
W, Rao
|
|
LV. Performance of rapid SOFIA Influenza A+B test compared to Luminex x-TAG respiratory viral panel assay in the diagnosis of influenza A, B, and subtype H3. J Investig Med
|
|
2016;<strong>64</strong>:905–7. [<a href="/pmc/articles/PMC4819670/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4819670</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/26911275" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26911275</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population – includes adults and children; outcomes not reported separately in adults. Not an RCT.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Shaikh
|
|
N, Martin, JM. Randomised controlled trial: delayed prescription worsens reported symptoms and increases antibiotic use compared with clinical score with or without rapid antigen testing in patients with sore throat. Evidence-based medicine
|
|
2014;<strong>19</strong>(3):117.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/24441077" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24441077</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication type – commentary.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Steurer
|
|
J, Held
|
|
U, Spaar
|
|
A, Bausch
|
|
B, Zoller
|
|
M, Hunziker
|
|
R, Bachmann
|
|
LM, et al. A decision aid to rule out pneumonia and reduce unnecessary prescriptions of antibiotics in primary care patients with cough and fever. BMC Med
|
|
2011;<strong>9</strong>:56.
|
|
[<a href="/pmc/articles/PMC3118372/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3118372</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/21569472" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21569472</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – not an RCT. No relevant comparator.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Stolz
|
|
D, Christ-Crain
|
|
M, Bingisser
|
|
R, Leuppi
|
|
J, Miedinger
|
|
D, Mϋller
|
|
C, et al. Antibiotic treatment of exacerbations of COPD: a randomized, controlled trial comparing procalcitonin-guidance with standard therapy. Chest
|
|
2007;<strong>131</strong>:9–19.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/17218551" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17218551</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population - patients hospitalised for COPD exacerbation (i.e. inpatients).</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Takemura
|
|
Y, Ishida
|
|
H, Saitoh
|
|
H, Kure
|
|
H, Kakoi
|
|
H, Ebisawa
|
|
K, et al. Antibiotic selection patterns in acutely febrile new outpatients with or without immediate testing for C reactive protein and leucocyte count. Journal of Clinical Pathology Journal of Clinical Pathology
|
|
2005;<strong>58</strong>(7):729–733.
|
|
[<a href="/pmc/articles/PMC1770720/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1770720</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/15976341" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15976341</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population - age not reported; therefore could include children.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Tang
|
|
J, Long
|
|
W, Yan
|
|
L, Zhang
|
|
Y, Xie
|
|
J, Lu
|
|
G, et al., Procalcitonin guided antibiotic therapy of acute exacerbations of asthma: a randomized controlled trial. BMC infectious diseases
|
|
2013;<strong>13</strong>:596.
|
|
[<a href="/pmc/articles/PMC3867421/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3867421</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24341820" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24341820</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention – test does not appear to be a POCT (laboratory test).</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Temte
|
|
J, Checovich
|
|
M, Mundt
|
|
M, Barlow
|
|
S, Hamrick
|
|
I, Reisdorf
|
|
E. Rapid Detection of Influenza Outbreaks in Long Term Care Facilities Reduces Emergency Room Visits and Hospitalization. Annals of family medicine
|
|
2023;<strong>21</strong>
|
|
Suppl 1. [<a href="/pmc/articles/PMC10549373/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC10549373</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/36944078" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36944078</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication type – conference abstract only.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Thornton
|
|
HV, Turner
|
|
KME, Harrison
|
|
S, Hammond
|
|
A, Hawcroft
|
|
C, Hay
|
|
AD. Assessing the potential of upper respiratory tract point-of-care testing: a systematic review of the prognostic significance of upper respiratory tract microbes. Clin Microbiol Infect
|
|
2019;<strong>25</strong>:1339–1346.
|
|
[<a href="/pmc/articles/PMC7129693/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7129693</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31254715" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31254715</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – systematic review of prognostic studies.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
True
|
|
BL, Carter
|
|
BL, Driscoll
|
|
CE, House
|
|
JD. Effect of a rapid diagnostic method on prescribing patterns and ordering of throat cultures for streptococcal pharyngitis. Journal of Family Practice
|
|
1986;<strong>23</strong>:215–9.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/3528381" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 3528381</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population – includes adults and children; outcomes not reported separately in adults. Not an RCT.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Urbiztondo, I., et al., Decreasing inappropriate use of antibiotics in primary care in four countries in south America—cluster randomized controlled trial. Antibiotics, 2017. 6(4). [<a href="/pmc/articles/PMC5745481/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5745481</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29240687" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29240687</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention – not a POCT (no tests involved)</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Van Buul
|
|
LW, Boere
|
|
TM, Hopstaken
|
|
RM, Van Tulder
|
|
MW, Twisk
|
|
JWMR, Verheij
|
|
TJM, et al. CRP Point-of-care Testing To Reduce Antibiotic Prescribing For Lower Respiratory Tract Infections In Nursing Home Residents. European geriatric medicine
|
|
2022;<strong>13</strong>:S338.
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Publication type – conference abstract only.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
van der Does
|
|
Y, Limper
|
|
M, Jie
|
|
KE, Schuit
|
|
SCE, Jansen
|
|
H, Pernot
|
|
N, et al. Procalcitonin-guided antibiotic therapy in patients with fever in a general emergency department population: a multicentre non-inferiority randomized clinical trial (HiTEMP study). Clinical microbiology and infection
|
|
2018;<strong>24</strong>(12):1282–1289.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/29870855" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29870855</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention – not a POCT (laboratory test).</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
van Vugt
|
|
SF, Broekhuizen
|
|
BD, Lammens
|
|
C, Zuithoff
|
|
NP, de Jong
|
|
PA, Coenen
|
|
S, et al. Use of serum C reactive protein and procalcitonin concentrations in addition to symptoms and signs to predict pneumonia in patients presenting to primary care with acute cough: Diagnostic study. BMJ
|
|
2013;<strong>346</strong>:f2450.
|
|
[<a href="/pmc/articles/PMC3639712/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3639712</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/23633005" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23633005</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparator – no relevant comparator. Not an RCT (diagnostic accuracy study).</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Wächtler
|
|
H, Kaduszkiewicz
|
|
H, Kuhnert
|
|
O, Malottki
|
|
KA, Maaß
|
|
S, Hedderich
|
|
J,. et al. Influence of a guideline or an additional rapid strep test on antibiotic prescriptions for sore throat: the cluster randomized controlled trial of HALS (Hals und Antibiotika Leitlinien Strategien). BMC primary care
|
|
2023;<strong>24</strong>(1):75.
|
|
[<a href="/pmc/articles/PMC10029262/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC10029262</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/36941540" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36941540</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population – includes adults and children; outcomes not reported separately in adults. Not all patients in the intervention group received a POCT.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Yang
|
|
JH, Huang
|
|
PY, Shie
|
|
SS, Yang
|
|
S, Tsao
|
|
KC, Wu
|
|
TL, et al. Di-agnostic performance of the Sofia(R) influenza A+B fluores-cent immunoassay in adult outpatients in Northern Taiwan. J Med Virol
|
|
2018;<strong>90</strong>:1010–8.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/29424435" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29424435</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparator – no relevant comparator. Not an RCT (diagnostic accuracy study).</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Yoo
|
|
J, Jung
|
|
CY, Na
|
|
JO, Kim
|
|
TH, Oh
|
|
YM, Ra
|
|
SW. Bacterial etiology and pneumococcal urinary antigen in moderate exacerbation of chronic obstructive pulmonary disease. Journal of thoracic disease
|
|
2022;<strong>14</strong>(7):2532–2543.
|
|
[<a href="/pmc/articles/PMC9344423/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9344423</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/35928620" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35928620</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design - not an RCT (<i>post hoc</i> analysis of an RCT but groups not randomised to interventions). No relevant comparator.</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Yoon
|
|
J, Yun
|
|
SG, Nam
|
|
J, Choi
|
|
SH, Lim
|
|
CS. The use of saliva specimens for detection of influenza A and B viruses by rapid influenza diagnostic tests. J Virol Methods
|
|
2017;<strong>243</strong>:15–9.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/28111058" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28111058</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparator – no relevant comparator. Not an RCT (diagnostic accuracy study).</td></tr><tr><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
Zhang
|
|
K, Xie
|
|
K, Zhang
|
|
C, Liang
|
|
Y, Chen
|
|
Z, Wang
|
|
H. C-reactive protein testing to reduce antibiotic prescribing for acute respiratory infections in adults: a systematic review and meta-analysis. Journal of Thoracic Disease
|
|
2022;<strong>14</strong>(1):123–134.
|
|
[<a href="/pmc/articles/PMC8828529/" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8828529</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/35242374" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35242374</span></a>]
|
|
</td><td headers="hd_h_niceng237er2.app7.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design – systematic review (reference list checked).</td></tr></tbody></table></div></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script><script type="text/javascript" src="/core/mathjax/2.7.9/MathJax.js?config=TeX-AMS-MML_SVG"> </script></div></div>
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