{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T01:09:54Z","timestamp":1789780194410,"version":"4.0.1"},"reference-count":21,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2015,3,17]],"date-time":"2015-03-17T00:00:00Z","timestamp":1426550400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To evaluate the diagnostic accuracy of symptoms, the symptom progression pattern, and clinical signs in identifying bacterial acute rhinosinusitis (ARS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>We conducted an inception cohort study among 50 military recruits with ARS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We collected symptoms daily from the onset of symptoms to approximately 10 days. At 9 to 10 days, standardized data on symptoms and physical findings were gathered. A positive culture of maxillary sinus aspirate was considered to be the reference standard for bacterial ARS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At 9 to 10 days, the presence or deterioration after 5 days of any of the symptoms could not be used to diagnose bacterial ARS. Toothache had an adequate positive likelihood ratio (positive likelihood ratio [LR+] 4.4) but was too rare to be used for screening. In contrast, several physical findings at 9 to 10 days were of more diagnostic use and frequent enough for screening. Moderate or profuse (vs. none\/minimal) amount of secretion in nasal passage seen in anterior rhinoscopy satisfactorily either ruled in, if present (LR+ 3.2), or ruled out, if absent (negative likelihood ratio 0.2), bacterial ARS. If any secretion was seen in the posterior pharynx or middle meatus, the probability of bacterial ARS increased markedly (LR+ 5.3 and LR+ 11.0, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We found symptoms or their change to be of little use in identifying bacterial ARS. In contrast, we observed several clinical findings after 9 to 10 days of symptoms to predict bacterial ARS quite accurately.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4. <jats:italic>Laryngoscope<\/jats:italic>, 125:1541\u20131546, 2015<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.25247","type":"journal-article","created":{"date-parts":[[2015,3,17]],"date-time":"2015-03-17T09:55:16Z","timestamp":1426586116000},"page":"1541-1546","source":"Crossref","is-referenced-by-count":12,"title":["Diagnostic accuracy of history and physical examination in bacterial acute rhinosinusitis"],"prefix":"10.1002","volume":"125","author":[{"given":"Timo J.","family":"Autio","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology and Medical Research Center Oulu Oulu University Hospital and University of Oulu Oulu"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo","family":"Koskenkorva","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Medical Research Center Oulu Oulu University Hospital and University of Oulu Oulu"},{"name":"Air Force Command Finland Finnish Defence Forces  Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mervi","family":"N\u00e4rki\u00f6","sequence":"additional","affiliation":[{"name":"Centre for Military Medicine Finnish Defence Forces  Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuomo K.","family":"Leino","sequence":"additional","affiliation":[{"name":"Air Force Command Finland Finnish Defence Forces  Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petri","family":"Koivunen","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Medical Research Center Oulu Oulu University Hospital and University of Oulu Oulu"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olli\u2010Pekka","family":"Alho","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Medical Research Center Oulu Oulu University Hospital and University of Oulu Oulu"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,3,17]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"349","article-title":"Use of antibiotics for adult upper respiratory infections in outpatient settings: a national ambulatory network study","volume":"38","author":"Gill JM","year":"2006","journal-title":"Fam Med"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.4193\/Rhino10.169"},{"key":"e_1_2_7_4_1","first-page":"3","article-title":"European position paper on rhinosinusitis and nasal polyps 2012","volume":"23","author":"Fokkens WJ","year":"2012","journal-title":"Rhinol 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