title: Diagnostic tools in respiratory tract infections: use and comparison with Finnish guidelines.
abstract: The objectives of this prospective epidemiological study were to describe the diagnosis and treatment of respiratory tract infections by Finnish general practitioners and to compare current practice with national evidence-based guidelines. All patients (n = 4386) seeking primary care for a respiratory tract infection for the first time in 30 health centres during 1 week in November 1998 participated in the study. The main outcome measures were the amounts and types of diagnostic tests used and antimicrobials prescribed. Tympanometry was used in 1% of patients with acute otitis media. Ultrasonography, sinus radiography or both were used in 80% of cases of sinusitis and antigen detection or culture for Streptococci in 57% of throat infections. In acute bronchitis, a chest radiograph was taken in 5% of cases and the CRP level determined in 8%. The corresponding figures for pneumonia were 49% and 39%. In pneumonia and throat infection, diagnostic testing was statistically significantly associated with the use of antimicrobials, but not in otitis, sinusitis or acute bronchitis. Diagnostic tests were underused in respiratory tract infections compared to evidence-based recommendations.
authors.affiliation: Department of Public Health Science and General Practice, University of Oulu, Oulu, Finland. Pekka.Honkanen@Kemi.fi
authors.forename: Pekka Olavi
authors.initials: PO
authors.lastname: Honkanen
authors.forename: Ulla-Maija
authors.initials: UM
authors.lastname: Rautakorpi
authors.forename: Pentti
authors.initials: P
authors.lastname: Huovinen
authors.forename: Timo
authors.initials: T
authors.lastname: Klaukka
authors.forename: Erkki
authors.initials: E
authors.lastname: Palva
authors.forename: Risto
authors.initials: R
authors.lastname: Roine
authors.forename: Hannu
authors.initials: H
authors.lastname: Sarkkinen
authors.forename: Helena
authors.initials: H
authors.lastname: Varonen
authors.forename: Marjukka
authors.initials: M
authors.lastname: Mäkelä
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D019317:Evidence-Based Medicine / Q000592:standards; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D008875:Middle Aged; D010821:Physicians, Family / Q000592:standards; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000188:drug therapy*