1. Diagnostic accuracy of physician’s gestalt in suspected COVID‐19: Prospective bicentric study
- Author
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Nazerian, Peiman, Morello, Fulvio, Prota, Alessio, Betti, Laura, Lupia, Enrico, Apruzzese, Luc, Oddi, Matteo, Grosso, Federico, Grifoni, Stefano, Pivetta, Emanuele, Catini, Elisabetta, Gualtieri, Simona, Casanova, Barbara, De Villa, Eleonora, Cerini, Gabriele, Lumini, Enrico, Gagliano, Manfredi, Annovi, Antonio, Mucaj, Sara, Albanesi, Marco, Cavigli, Edoardo, Moroni, Chiara, Miele, Vittorio, Lagi, Fillippo, Fanelli, Alessandra, Rossolini, Gian Maria, Turco, Lucia, Tomaiuolo, Matteo, Paolini, Diana, Tonietti, Barbara, Tizzani, Maria, Locatelli, Stefania M, Porrino, Giulio, Losano, Isabel, Leone, Dario, Calzolari, Gilberto, Versan, Matteo, Steri, Fabio, Ardito, Arianna, Capuano, Marialessia, Gelardi, Maria, Silvestri, Giulia, Tutto, Stefania, Avolio, Maria, Cavallo, Rosanna, Bartalucci, Alice, Paglieri, Cristina, Baldassa, Federico, Baron, Paolo, Bianchi, Giordano, Busso, Valeria, Conterno, Andrea, Del Rizzo, Paola, Fascio Pecetto, Paolo, Giachino, Francesca, Iannacone, Andrea, Ferrera, Patrizia, Riccardini, Franco, Sacchi, Claudia, Sozzi, Michela, Totaro, Silvia, Visconti, Pasqualina, Risi, Francesca, Basile, Francesca, Baricocchi, Denise, Beaux, Alessia, Valentina, Beaux, Bima, Paolo, Cara, Irene, Chichizola, Liliana, Dellavalle, Francesca, Labarile, Giulia, Ottimo, Marco, Pia, Ilaria, Scategni, Virginia, and Surra, Astrid
- Subjects
lung ultrasound chest x-ray ,medicine.medical_specialty ,emergency department ,Coronavirus disease 2019 (COVID-19) ,diagnosis ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,lung ultrasound chest x‐ray ,Diagnostic accuracy ,Sensitivity and Specificity ,03 medical and health sciences ,0302 clinical medicine ,COVID‐19 ,Physicians ,Internal medicine ,Humans ,Medicine ,Prospective Studies ,SARS-CoV-2 ,business.industry ,Area under the curve ,COVID-19 ,Diagnostic test ,030208 emergency & critical care medicine ,Original Contribution ,General Medicine ,Emergency department ,gestalt ,Lung ultrasound ,Emergency Medicine ,Gestalt psychology ,Coronavirus Infections ,business - Abstract
Objectives Physicians’ gestalt is central in the diagnostic pipeline of suspected COVID‐19, due to the absence of a single tool allowing conclusive rule in or rule out. The aim of this study was to estimate the diagnostic test characteristics of physician's gestalt for COVID‐19 in the emergency department (ED), based on clinical findings or on a combination of clinical findings and bedside imaging results. Methods From April 1 to April 30, 2020, patients with suspected COVID‐19 were prospectively enrolled in two EDs. Physicians prospectively dichotomized patients in COVID‐19 likely or unlikely twice: after medical evaluation of clinical features (clinical gestalt [CG]) and after evaluation of clinical features and results of lung ultrasound or chest x‐ray (clinical and bedside imaging–integrated gestalt [CBIIG]). The final diagnosis was adjudicated after independent review of 30‐day follow‐up data. Results Among 838 ED enrolled patients, 193 (23%) were finally diagnosed with COVID‐19. The area under the curve (AUC), sensitivity, and specificity of CG and CBIIG for COVID‐19 were 80.8% and 91.6% (p
- Published
- 2021
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