182 Chapter 5 Target population Adult primary care patients with cough < 3 weeks and suspicion of pneumonia (based on history and physical examination) without being seriously ill Test • CRP point of care test • Purpose: diagnosis • Role in testmanagement pathway: add-on test beyond history taking and physical examination Test result • < 20: negative • 20 – 100: inconclusive • > 100: positive Including undesirable consequences (burden, side effects, societal costs) related to the test • Fear • Pain • Costs • Consultation time Impact on people-important outcomes • TP: correct diagnosis and treatment: decreased hospitalization and mortality risk drug side effects • FP: incorrect diagnosis and treatment: no decreased hospitalization and mortality risk drug side effects • TN: correct diagnosis of no bacterial pneumonia: reduced antimicrobial resistance • FN: incorrect diagnosis of no bacterial pneumonia: increased hospitalization and mortality risk • Inconclusive: varying hospitalization and mortality risk drug side effects in patients treated with antibiotics Interpretation of test results and subsequent management • Positive: bacterial pneumonia and treatment with antibiotics • Negative: no bacterial pneumonia and watchful waiting • Inconclusive: management determined by other clinical considerations and shared decision making Including undesirable consequences (burden, side effects, societal costs) related to management • Side effects of drug treatment (c).
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