Signs and Evidence

Making clinical sense of scientific data

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Fever

Upper respiratory infection
 Positive likelihood ratio
0.73 ( Nader Shaikh et al. )
(average) 0.73
Negative likelihood ratio
1.26 ( Nader Shaikh et al. )
(average) 1.26
Mononucleosis
 Positive likelihood ratio
1.70 ( Mark H et al. )
(average) 1.7
Negative likelihood ratio
0.87 ( Mark H et al. )
(average) 0.87
Streptococcal pharyngitis
 Positive likelihood ratio
1.65 ( Aalbers J et al. )
(average) 1.65
Negative likelihood ratio
0.71 ( Aalbers J et al. )
(average) 0.71
Acute sinusitis
 Positive likelihood ratio
1.00 ( Claude Cyr et al. )
(average) 1
Negative likelihood ratio
1.00 ( Claude Cyr et al. )
(average) 1
Cholecystitis
 Positive likelihood ratio
1.50 ( Trowbridge RL et al. )
(average) 1.5
Negative likelihood ratio
0.90 ( Trowbridge RL et al. )
(average) 0.9
Otitis media acuta
 Positive likelihood ratio
0.80 ( R Rothman et al. )
0.77 ( Wood JM et al. )
(average) 0.79
Negative likelihood ratio
1.30 ( R Rothman et al. )
1.25 ( Wood JM et al. )
(average) 1.28
Pneumonia in children
 Positive likelihood ratio
1.06 ( Rambaud-Althaus C et al. )
1.10 ( Shah SN et al. )
2.21 ( Zanco J et al. )
(average) 1.46
Negative likelihood ratio
0.53 ( Rambaud-Althaus C et al. )
0.59 ( Shah SN et al. )
0.23 ( Zanco J et al. )
(average) 0.45
Urinary tract infection in women
 Positive likelihood ratio
1.25 ( Giesen LGM et al. )
1.60 ( Bent S et al. )
(average) 1.43
Negative likelihood ratio
0.98 ( Giesen LGM et al. )
0.90 ( Bent S et al. )
(average) 0.94
Diverticulitis
 Positive likelihood ratio
1.40 ( Wilkins T et al. )
(average) 1.4
Negative likelihood ratio
0.80 ( Wilkins T et al. )
(average) 0.8
Pneumonia in adults
 Positive likelihood ratio
2.73 ( Holm A et al. )
1.70 ( Heckerling PS et al. )
(average) 2.22
Negative likelihood ratio
0.79 ( Holm A et al. )
0.59 ( Heckerling PS et al. )
(average) 0.69
Appendicitis
 Positive likelihood ratio
3.20 ( Wagner JM et al. )
1.06 ( Nshuti R et al. )
1.03 ( Idris SA et al. )
1.07 ( Al-gaithy Zuhoor K et )
(average) 1.59
Negative likelihood ratio
0.40 ( Wagner JM et al. )
0.99 ( Nshuti R et al. )
0.95 ( Idris SA et al. )
0.33 ( Al-gaithy Zuhoor K et )
(average) 0.67
Temporal Arteritis
 Positive likelihood ratio
1.38 ( Ryan D et al. )
(average) 1.38
Negative likelihood ratio
0.90 ( Ryan D et al. )
(average) 0.9


Sources used:

1.Nader Shaikh et al. Signs and Symptoms that Differentiate Acute Sinusitis from Viral Upper Respiratory Tract Infection. Pediatr Infect Dis J. 2013 Oct; 32(10): 1061–1065.
2.Mark H et al. Epstein-Barr Virus Infectious Mononucleosis. Am Fam Physician. 2004 Oct 1;70(7):1279-1287.
3.Aalbers J et al. Predicting streptococcal pharyngitis in adults in primary care: a systematic review of the diagnostic accuracy of symptoms and signs and validation of the Centor score. BMC Medicine20119:67
4.Claude Cyr et al. Do symptoms and initial clinical probability predict the radiological diagnosis of acute sinusitis in children? Paediatr Child Health. 2001 Oct; 6(8): 536–539.
5.Trowbridge RL et al. Does This Patient Have Acute Cholecystitis? JAMA, January 1, 2003—Vol 289, No. 1 80-86
6.R Rothman et al. Does this child have acute otitis media? JAMA. 2003 Sep 24;290(12):1633-40
7.Rambaud-Althaus C et al. Waarde van symptomen en klinische tekens voor de diagnose van pneumonie bij kinderen. Minerva 2015 Volume 14 Nummer 6, 66 - 67
8.Giesen LGM et al. Predicting acute uncomplicated urinary tract infection in women: a systematic review of the diagnostic accuracy of symptoms and signs. BMC Family Practice 2010 11:78
9.Bent S et al. Does this woman have an acute uncomplicated urinary tract infection? JAMA 2002 May 22, 287 (20): 2701-10
10.Wilkins T et al. Diagnosis and Management of Acute Diverticulitis. Am Fam Physician. 2013 May 1;87(9):612-620
11.Holm A et al. Aetiology and prediction of pneumonia in lower respiratory tract infection in primary care. Br J Gen Pract. 2007 Jul 1; 57(540): 547–554
12.Heckerling PS et al. Clinical prediction rule for pulmonary infiltrates. Annals of Internal Medicine 1990 November 1, 113 (9): 664-70
13.Shah SN et al. Does This Child Have Pneumonia?: The Rational Clinical Examination Systematic Review. JAMA. 2017 Aug 1;318(5):462-471
14.Wagner JM et al. Does This Patient Have Appendicitis? JAMA. 1996;276(19):1589-1594
15.Nshuti R et al. Clinical presentation of acute appendicitis in adults at the Chris Hani Baragwanath academic hospital. Int J Emerg Med. 2014; 7: 12
16.Idris SA et al. The sensitivity and specificity of the conventional symptoms and signs in making adiagnosis of acute appendicitis. Sudan journal of medical sciences. 4. 55-61
17.Zanco J et al. Analysis of chest x-ray and clinical finding in children with pneumonia. Med. Sci., Vol. 17, No. (2), 2013 477-481
18.Al-gaithy Zuhoor K et al. Clinical value of total white blood cells and neutrophil counts in patients with suspected appendicitis: retrospective study. World Journal of Emergency Surgery : WJES. 2012;7:32
19.Ryan D et al. Management of the Patient with Suspected Temporal Arteritis. Ophthalmology 2005;112:744–756
20.Wood JM et al. Acute otitis media in young children Diagnosis and management. Medicine Today 2014; 15(7): 12-2