Concordance between Patient and Physician Predictions of PCR Results and Predictive Capacity of Presenting Complaints in Suspected Infectious Diseases

Abstract

Introduction: The aim of this study was to investigate the concordance between patient and physician predictions of polymerase chain reaction (PCR) results in suspected infectious diseases and evaluate the predictive capacity of presenting complaints to enhance diagnostic decision-making. Methods: A cross-sectional design was employed to recruit 1,369 participants with symptoms associated with coronavirus disease-2019 (COVID-19) infection. Data on demographics, medical history, presenting complaints, and PCR results were collected. Concordance between patient and physician predictions was assessed using kappa statistics, providing insights into the alignment of patient beliefs and physician expectations. Results: The study revealed a lack of concordance between patient and physician predictions of PCR results. Loss of taste and smell emerged as the most sensitive symptoms associated with positive PCR results, whereas cough demonstrated higher specificity. However, relying solely on these symptoms may lead to missed cases, emphasizing the need for a comprehensive clinical evaluation. The suboptimal predictive accuracy of both patients and physicians highlights the importance of incorporating objective diagnostic tools such as PCR testing to enhance diagnostic decision-making. Conclusion: Improved communication and shared decision making between patients and physicians are crucial for optimizing diagnostic strategies. Integrating objective diagnostic tools with clinical judgment is essential for improving accuracy. By identifying specific symptoms strongly associated with positive PCR results, this study contributes to enhancing the efficiency of diagnostic decision-making and the development of evidence-based guidelines in the realm of infectious diseases, ultimately improving patient care and healthcare delivery.

Keywords

• physcian-patient relations
• infectious diseases medicine
• emergency medicine
• covid-19