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D

iagnostic

accuracy

of

respiratory

diseases

in

primary

health

units

R

ev

A

ssoc

M

ed

B

ras

2014; 60(6):599-612

601

R

esults

Thirty of the 3,913 articles encountered were selected ac-

cording to the following flowchart (Figure 2).

Articles assessing the diseases of interest were not

found in this set. The methodological heterogeneity en-

countered did not meet the criteria for conducting a me-

ta-analysis. The results will be presented organized as fol-

lows: acute respiratory infections, tuberculosis, asthma,

COPD, and asthma and COPD in conjunction.

Acute respiratory infections - ARI

Upper respiratory tract infections

Among studies of upper respiratory tract infections (URTI), two

usedC-reactive protein (CRP) or used it as diagnostic aid, or as

a referencemethod for assessment of diagnostic accuracy.

A single study verified the accuracy of the upper res-

piratory tract disease diagnosis. The authors evaluated

the accuracy of the clinical diagnosis of pharyngitis using

CRP dosage and leukocyte count in the two phases of the

study.

13

Another study also used the CRP as an auxiliary

tool in the diagnosis of acute bacterial rhinosinusitis and

prescription of antibiotics.

14

Only one study assessed the concordance between ge-

neral practitioners and specialists (pediatricians and ENT

specialists) through a standardized questionnaire in the

management of children with recurrent tonsillitis. The-

re was disagreement between the signs and symptoms

evaluated by the ENT specialists and general practitio-

ners in the diagnosis of tonsillitis, pharyngitis or upper

respiratory tract infection.

15

Lower respiratory tract infections

Studies assessing the concordance or comparing the diag-

nosis and conduct of general physicians and specialists

for lower respiratory tract infections were not encounte-

red. The few studies encountered compared the diagno-

sis by general practitioners with a reference exam and are

grouped in Table 1.

11

Articles selected for

the study n = 30

Articles retrieved by the search strategy n = 3,913

Repeated articles n = 117

Articles excluded after reading the title:

Respiratory infections = 1,128

Asthma = 1,124

COPD = 723

TB = 529

Articles excluded after reading the abstract:

Respiratory infections = 26

Asthma = 50

COPD = 49

TB = 21

Articles excluded after reading the article:

Respiratory infections = 28

Asthma = 38

COPD = 42

TB = 8

Figure 2

 Flowchart for selection of articles according to the criteria adopted in the review.