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.