Please use this identifier to cite or link to this item:
http://hdl.handle.net/1942/26602
Full metadata record
DC Field | Value | Language |
---|---|---|
dc.contributor.author | BRUYNDONCKX, Robin | - |
dc.contributor.author | HENS, Niel | - |
dc.contributor.author | Verheij, Theo J. M. | - |
dc.contributor.author | AERTS, Marc | - |
dc.contributor.author | Ieven, Margareta | - |
dc.contributor.author | Butler, Christopher C. | - |
dc.contributor.author | Little, Paul | - |
dc.contributor.author | Goossens, Herman | - |
dc.contributor.author | Coenen, Samuel | - |
dc.date.accessioned | 2018-08-06T11:12:19Z | - |
dc.date.available | 2018-08-06T11:12:19Z | - |
dc.date.issued | 2018 | - |
dc.identifier.citation | BRITISH JOURNAL OF GENERAL PRACTICE, 68(670), p. E342-E350 | - |
dc.identifier.issn | 0960-1643 | - |
dc.identifier.uri | http://hdl.handle.net/1942/26602 | - |
dc.description.abstract | Background Accurate prediction of the course of an acute cough episode could curb antibiotic overprescribing, but is still a major challenge in primary care. Aim The authors set out to develop a new prediction rule for poor outcome (re-consultation with new or worsened symptoms, or hospital admission) in adults presenting to primary care with acute cough. Design and setting Data were collected from 2604 adults presenting to primary care with acute cough or symptoms suggestive of lower respiratory tract infection (LRTI) within the Genomics to combat Resistance against Antibiotics in Community-acquired LRTI in Europe (GRACE; www.grace-lrti.org) Network of Excellence. Method Important signs and symptoms for the new prediction rule were found by combining random forest and logistic regression modelling. Performance to predict poor outcome in acute cough patients was compared with that of existing prediction rules, using the models' area under the receiver operator characteristic curve (AUC), and any improvement obtained by including additional test results (C-reactive protein [CRP], blood urea nitrogen [BUN], chest radiography, or aetiology) was evaluated using the same methodology. Results The new prediction rule, included the baseline Risk of poor outcome, Interference with daily activities, number of years stopped Smoking (> or < 45 years), severity of Sputum, presence of Crackles, and diastolic blood pressure (> or < 85 mmHg) (RISSC85). Though performance of RISSC85 was moderate (sensitivity 62%, specificity 59%, positive predictive value 27%, negative predictive value 86%, AUC 0.63, 95% confidence interval [CI] = 0.61 to 0.67), it outperformed all existing prediction rules used today (highest AUC 0.53, 95% CI = 0.51 to 0.56), and could not be significantly improved by including additional test results (highest AUC 0.64, 95% CI = 0.62 to 0.68). Conclusion The new prediction rule outperforms all existing alternatives in predicting poor outcome in adult patients presenting to primary care with acute cough and could not be improved by including additional test results. | - |
dc.description.sponsorship | The Genomics to combat Resistance against Antibiotics in Community-acquired LRTI in Europe (GRACE) was funded by the European Community's Sixth Framework Programme (grant agreement 518226). Work in the UK was also supported by the National Institute for Health Research (NIHR), in Barcelona by 2009 SGR 911 Ciber de Enfermedades Respiratorias (Ciberes CB06/06/0028), and in Belgium by the Research Foundation, Flanders (FWO; G.0274.08N). Financial support from the Methusalem financing programme of the Flemish Government is also gratefully acknowledged. This publication has been financially supported through the European Science Foundation, in the framework of the Research Networking Program TRACE (www.esf.org/trace). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Niel Hens acknowledges support from the University of Antwerp scientific chair in evidence-based vaccinology, financed in 2009-2017 by an unrestricted gift from Pfizer and GSK. | - |
dc.language.iso | en | - |
dc.publisher | ROYAL COLL GENERAL PRACTITIONERS | - |
dc.rights | © British Journal of General Practice 2018 | - |
dc.subject.other | acute cough; clinical prediction rule; primary care; prognosis | - |
dc.subject.other | acute cough; clinical prediction rule; primary care; prognosis | - |
dc.title | Development of a prediction tool for patients presenting with acute cough in primary care: a prognostic study spanning six European countries | - |
dc.type | Journal Contribution | - |
dc.identifier.epage | E350 | - |
dc.identifier.issue | 670 | - |
dc.identifier.spage | E342 | - |
dc.identifier.volume | 68 | - |
local.format.pages | 9 | - |
local.bibliographicCitation.jcat | A1 | - |
dc.description.notes | [Bruyndonckx, Robin] Hasselt Univ, Hasselt, Belgium. [Hens, Niel; Aerts, Marc] Hasselt Univ, Biostat, Hasselt, Belgium. [Bruyndonckx, Robin; Hens, Niel] Univ Antwerp, Antwerp, Belgium. [Ieven, Margareta; Goossens, Herman] Univ Antwerp, Ctr Gen Practice, Med Microbiol, Antwerp, Belgium. [Coenen, Samuel] Univ Antwerp, Ctr Gen Practice, Antwerp, Belgium. [Verheij, Theo J. M.] Univ Med Ctr Utrecht, Gen Practice, Utrecht, Netherlands. [Butler, Christopher C.] Cardiff Univ, Primary Care, Cardiff, S Glam, Wales. [Little, Paul] Univ Southampton, Primary Care Res, Southampton, Hants, England. | - |
local.publisher.place | LONDON | - |
local.type.refereed | Refereed | - |
local.type.specified | Article | - |
dc.identifier.doi | 10.3399/bjgp18X695789 | - |
dc.identifier.isi | 000430972900005 | - |
item.validation | ecoom 2019 | - |
item.fullcitation | BRUYNDONCKX, Robin; HENS, Niel; Verheij, Theo J. M.; AERTS, Marc; Ieven, Margareta; Butler, Christopher C.; Little, Paul; Goossens, Herman & Coenen, Samuel (2018) Development of a prediction tool for patients presenting with acute cough in primary care: a prognostic study spanning six European countries. In: BRITISH JOURNAL OF GENERAL PRACTICE, 68(670), p. E342-E350. | - |
item.contributor | BRUYNDONCKX, Robin | - |
item.contributor | HENS, Niel | - |
item.contributor | Verheij, Theo J. M. | - |
item.contributor | AERTS, Marc | - |
item.contributor | Ieven, Margareta | - |
item.contributor | Butler, Christopher C. | - |
item.contributor | Little, Paul | - |
item.contributor | Goossens, Herman | - |
item.contributor | Coenen, Samuel | - |
item.accessRights | Restricted Access | - |
item.fulltext | With Fulltext | - |
crisitem.journal.issn | 0960-1643 | - |
crisitem.journal.eissn | 1478-5242 | - |
Appears in Collections: | Research publications |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
10.3399@bjgp18X695789.pdf Restricted Access | Published version | 158.86 kB | Adobe PDF | View/Open Request a copy |
WEB OF SCIENCETM
Citations
4
checked on May 8, 2024
Page view(s)
58
checked on Jun 21, 2022
Download(s)
38
checked on Jun 21, 2022
Google ScholarTM
Check
Altmetric
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.