FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2068385344> ?p ?o ?g. }

• W2068385344 endingPage "214" @default.
• W2068385344 startingPage "214" @default.
• W2068385344 abstract "Demetrios Kyriacou and colleagues (July 31, p 449)1Kyriacou DN Stein AC Yarnold PR et al.Clinical predictors of bioterrorism-related inhalational anthrax.Lancet. 2004; 364: 449-452Summary Full Text Full Text PDF PubMed Scopus (34) Google Scholar nicely describe the differences in various symptoms and signs between a substantial series of cases with inhalation anthrax and cases with community-acquired pneumonia or influenza-like illness. Mediastinal widening or pleural effusion on chest radiography was the most accurate predictor of anthrax compared with the other clinical syndromes. Kyriacou and colleagues state that “Limitation of the effects of such an attack [of anthrax] requires rapid and accurate recognition of early victims …” and note their findings could be used in syndromic surveillance systems although with caveats related to limitations of their study. The accompanying Comment (p 393)2Mogridge J Anthrax and bioterrorism: are we prepared?.Lancet. 2004; 364: 393-395Summary Full Text Full Text PDF PubMed Scopus (4) Google Scholar tends to support this view.We do not believe these findings would be useful for syndromic surveillance—eg, “to enable earlier detection of [bioterrorism-related] epidemics and a more timely public health response, hours or days before disease clusters are recognized clinically, or before specific diagnoses are made and reported to public health authorities …”.3Buehler JW Berkelman RL Hartley DM Peters CJ Syndromic surveillance and bioterrorism-related epidemics.Emerg Infect Dis. 2003; 9: 1197-1204Crossref PubMed Scopus (170) Google Scholar Outside of a recognised exposure situation—eg, laboratory accident or bioterror attack—inhalation anthrax is an extremely unlikely diagnosis and the pretest probability of anthrax is very low; hence, although the likelihood ratios in the study are high for some signs and symptoms, particularly the aforementioned chest radiographic findings, the post-test probability of anthrax given the signs and symptoms is extremely low.As a crude example, in 2001 in the USA an estimated 4·5 million Americans sought medical attention for community acquired pneumonia4Niederman MS McCombs JS Unger AN Kumar A Popovian R The cost of treating community-acquired pneumonia.Clin Ther. 1998; 20: 820-837Summary Full Text PDF PubMed Scopus (485) Google Scholar and 11 cases of inhalation anthrax were diagnosed.1Kyriacou DN Stein AC Yarnold PR et al.Clinical predictors of bioterrorism-related inhalational anthrax.Lancet. 2004; 364: 449-452Summary Full Text Full Text PDF PubMed Scopus (34) Google Scholar The pretest probability of inhalation anthrax is, therefore, 0·0000024 and, given mediastinal widening, the post-test probability is 0·00003.5Deeks JJ Altman DG Diagnostic tests 4: likelihood ratios.BMJ. 2004; 329: 168-169Crossref PubMed Google Scholar In 2000, 2002, and 2003, with no cases of inhalation anthrax, the pretest and post-test probabilities are zero.At such miniscule or absent post-test probabilities, cases with the signs and symptoms described by Kyriacou and colleagues are unlikely to be recognised as (potentially) anthrax unless there was substantial clustering—ie, the aim of rapid and accurate recognition of cases will probably not be met. This likelihood is exacerbated by the third limitation mentioned by Kyriacou and co-workers, that signs and symptoms that are indicative of anthrax might well present fairly late in the clinical evolution of the case and, hence, not be helpful in early recognition.We declare that we have no conflict of interest. Demetrios Kyriacou and colleagues (July 31, p 449)1Kyriacou DN Stein AC Yarnold PR et al.Clinical predictors of bioterrorism-related inhalational anthrax.Lancet. 2004; 364: 449-452Summary Full Text Full Text PDF PubMed Scopus (34) Google Scholar nicely describe the differences in various symptoms and signs between a substantial series of cases with inhalation anthrax and cases with community-acquired pneumonia or influenza-like illness. Mediastinal widening or pleural effusion on chest radiography was the most accurate predictor of anthrax compared with the other clinical syndromes. Kyriacou and colleagues state that “Limitation of the effects of such an attack [of anthrax] requires rapid and accurate recognition of early victims …” and note their findings could be used in syndromic surveillance systems although with caveats related to limitations of their study. The accompanying Comment (p 393)2Mogridge J Anthrax and bioterrorism: are we prepared?.Lancet. 2004; 364: 393-395Summary Full Text Full Text PDF PubMed Scopus (4) Google Scholar tends to support this view. We do not believe these findings would be useful for syndromic surveillance—eg, “to enable earlier detection of [bioterrorism-related] epidemics and a more timely public health response, hours or days before disease clusters are recognized clinically, or before specific diagnoses are made and reported to public health authorities …”.3Buehler JW Berkelman RL Hartley DM Peters CJ Syndromic surveillance and bioterrorism-related epidemics.Emerg Infect Dis. 2003; 9: 1197-1204Crossref PubMed Scopus (170) Google Scholar Outside of a recognised exposure situation—eg, laboratory accident or bioterror attack—inhalation anthrax is an extremely unlikely diagnosis and the pretest probability of anthrax is very low; hence, although the likelihood ratios in the study are high for some signs and symptoms, particularly the aforementioned chest radiographic findings, the post-test probability of anthrax given the signs and symptoms is extremely low. As a crude example, in 2001 in the USA an estimated 4·5 million Americans sought medical attention for community acquired pneumonia4Niederman MS McCombs JS Unger AN Kumar A Popovian R The cost of treating community-acquired pneumonia.Clin Ther. 1998; 20: 820-837Summary Full Text PDF PubMed Scopus (485) Google Scholar and 11 cases of inhalation anthrax were diagnosed.1Kyriacou DN Stein AC Yarnold PR et al.Clinical predictors of bioterrorism-related inhalational anthrax.Lancet. 2004; 364: 449-452Summary Full Text Full Text PDF PubMed Scopus (34) Google Scholar The pretest probability of inhalation anthrax is, therefore, 0·0000024 and, given mediastinal widening, the post-test probability is 0·00003.5Deeks JJ Altman DG Diagnostic tests 4: likelihood ratios.BMJ. 2004; 329: 168-169Crossref PubMed Google Scholar In 2000, 2002, and 2003, with no cases of inhalation anthrax, the pretest and post-test probabilities are zero. At such miniscule or absent post-test probabilities, cases with the signs and symptoms described by Kyriacou and colleagues are unlikely to be recognised as (potentially) anthrax unless there was substantial clustering—ie, the aim of rapid and accurate recognition of cases will probably not be met. This likelihood is exacerbated by the third limitation mentioned by Kyriacou and co-workers, that signs and symptoms that are indicative of anthrax might well present fairly late in the clinical evolution of the case and, hence, not be helpful in early recognition. We declare that we have no conflict of interest. Clinical predictors of bioterrorism-related inhalational anthraxAuthor's response Full-Text PDF" @default.
• W2068385344 created "2016-06-24" @default.
• W2068385344 creator A5034141476 @default.
• W2068385344 creator A5060880175 @default.
• W2068385344 date "2005-01-01" @default.
• W2068385344 modified "2023-09-23" @default.
• W2068385344 title "Clinical predictors of bioterrorism-related inhalational anthrax" @default.
• W2068385344 cites W2003740803 @default.
• W2068385344 cites W2010851865 @default.
• W2068385344 cites W2050343982 @default.
• W2068385344 cites W2070882550 @default.
• W2068385344 cites W2113622101 @default.
• W2068385344 doi "https://doi.org/10.1016/s0140-6736(05)17736-8" @default.
• W2068385344 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/15652600" @default.
• W2068385344 hasPublicationYear "2005" @default.
• W2068385344 type Work @default.
• W2068385344 sameAs 2068385344 @default.
• W2068385344 citedByCount "3" @default.
• W2068385344 countsByYear W20683853442018 @default.
• W2068385344 crossrefType "journal-article" @default.
• W2068385344 hasAuthorship W2068385344A5034141476 @default.
• W2068385344 hasAuthorship W2068385344A5060880175 @default.
• W2068385344 hasConcept C147483822 @default.
• W2068385344 hasConcept C167508917 @default.
• W2068385344 hasConcept C177713679 @default.
• W2068385344 hasConcept C203014093 @default.
• W2068385344 hasConcept C2777289321 @default.
• W2068385344 hasConcept C2780239966 @default.
• W2068385344 hasConcept C2780801004 @default.
• W2068385344 hasConcept C3017944768 @default.
• W2068385344 hasConcept C523546767 @default.
• W2068385344 hasConcept C54355233 @default.
• W2068385344 hasConcept C545542383 @default.
• W2068385344 hasConcept C71924100 @default.
• W2068385344 hasConcept C86803240 @default.
• W2068385344 hasConceptScore W2068385344C147483822 @default.
• W2068385344 hasConceptScore W2068385344C167508917 @default.
• W2068385344 hasConceptScore W2068385344C177713679 @default.
• W2068385344 hasConceptScore W2068385344C203014093 @default.
• W2068385344 hasConceptScore W2068385344C2777289321 @default.
• W2068385344 hasConceptScore W2068385344C2780239966 @default.
• W2068385344 hasConceptScore W2068385344C2780801004 @default.
• W2068385344 hasConceptScore W2068385344C3017944768 @default.
• W2068385344 hasConceptScore W2068385344C523546767 @default.
• W2068385344 hasConceptScore W2068385344C54355233 @default.
• W2068385344 hasConceptScore W2068385344C545542383 @default.
• W2068385344 hasConceptScore W2068385344C71924100 @default.
• W2068385344 hasConceptScore W2068385344C86803240 @default.
• W2068385344 hasIssue "9455" @default.
• W2068385344 hasLocation W20683853441 @default.
• W2068385344 hasLocation W20683853442 @default.
• W2068385344 hasOpenAccess W2068385344 @default.
• W2068385344 hasPrimaryLocation W20683853441 @default.
• W2068385344 hasRelatedWork W1757308232 @default.
• W2068385344 hasRelatedWork W2024981220 @default.
• W2068385344 hasRelatedWork W2097143198 @default.
• W2068385344 hasRelatedWork W2132593497 @default.
• W2068385344 hasRelatedWork W2133889960 @default.
• W2068385344 hasRelatedWork W2172809429 @default.
• W2068385344 hasRelatedWork W2397151450 @default.
• W2068385344 hasRelatedWork W2472031570 @default.
• W2068385344 hasRelatedWork W2529472627 @default.
• W2068385344 hasRelatedWork W2991492028 @default.
• W2068385344 hasVolume "365" @default.
• W2068385344 isParatext "false" @default.
• W2068385344 isRetracted "false" @default.
• W2068385344 magId "2068385344" @default.
• W2068385344 workType "article" @default.