General Practice / Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Research, Education, Development & Innovation, Primary Health Care, Region Västra Götaland, Borås, Sweden.
BMJ Open. 2021 Jun 4;11(6):e042816. doi: 10.1136/bmjopen-2020-042816.
The main objective of this review was to describe and quantify the association between (FN) and acute sore throat in primary healthcare (PHC).
In this systematic review and meta-analysis, we searched Scopus and PubMed for case-control studies reporting the prevalence of FN in patients attending primary care for an uncomplicated acute sore throat as well as in healthy controls. Only studies published in English were considered. Publications were not included if they were case studies, or if they included patients prescribed antibiotics before the throat swab, patients with a concurrent malignant disease, on immunosuppression, having an HIV infection, or patients having another acute infection in addition to a sore throat. Inclusion criteria and methods were specified in advance and published in PROSPERO. The primary outcome was positive etiologic predictive value (P-EPV), quantifying the probability for an association between acute sore throat and findings of FN in the pharynx. For comparison, our secondary outcome was the corresponding P-EPV for group A (GAS).
PubMed and Scopus yielded 258 and 232 studies, respectively. Removing duplicates and screening the abstracts resulted in 53 studies subsequently read in full text. For the four studies of medium to high quality included in the meta-analysis, the cumulative P-EPV regarding FN was 64% (95% CI 33% to 83%). GAS, based on data from the same publications and patients, yielded a positive EPV of 93% (95% CI 83% to 99%).
The results indicate that FN may play a role in PHC patients with an acute sore throat, but the association is much weaker compared with GAS.
本综述的主要目的是描述和量化 （FN） 与初级保健（PHC）中急性咽痛之间的关联。
在这项系统回顾和荟萃分析中，我们在 Scopus 和 PubMed 中搜索了报告在因单纯性急性咽痛而就诊于初级保健的患者以及健康对照者中 FN 患病率的病例对照研究。仅考虑发表英文的研究。如果出版物是病例研究，或者如果它们包括在喉咙拭子前开抗生素的患者、患有并发恶性肿瘤的患者、正在接受免疫抑制治疗的患者、患有 HIV 感染的患者或除咽痛外还有另一种急性感染的患者，则不包括这些出版物。纳入标准和方法已事先指定并在 PROSPERO 中公布。主要结局是阳性病因预测值（P-EPV），用于量化咽 FN 与急性咽痛之间的关联概率。作为比较，我们的次要结局是 A 组 （GAS） 的相应 P-EPV。
PubMed 和 Scopus 分别产生了 258 项和 232 项研究。去除重复项并筛选摘要后，有 53 项研究随后全文阅读。对于纳入荟萃分析的四项质量中等或较高的研究，FN 的累积 P-EPV 为 64%（95%CI 33%至 83%）。基于来自相同出版物和患者的数据，GAS 的阳性 EPV 为 93%（95%CI 83%至 99%）。
结果表明，FN 可能在 PHC 中出现急性咽痛的患者中起作用，但与 GAS 相比，这种关联要弱得多。
