Study designs of evaluations included in the review
There were no reported inclusion criteria for the study design. The types of design employed by the included studies were unclear.
Specific interventions included in the review
Studies were included if clinical symptoms, signs and blood tests were stated as the index test. The included studies assessed the following signs and symptoms: purulent secretion in the nasal cavity, pain in bending forward and transillumination of the sinus (signs); purulent rhinorrohoea, pain in the teeth, beginning with common cold, unilateral maxillary pain, two phases in history, and a lack of response to nasal decongestants (symptoms).
Reference standard test against which the new test was compared
Studies were included if an objective reference standard was used. Sinus puncture, computed tomography (CT), X-ray, or ultrasonography were accepted reference standards. Sinus puncture was treated as positive if it revealed purulent or mucopurulent secretion. Ultrasound findings were considered positive if there were scans of a back wall echo greater than 3.5 cm from the initial echo; sinus radiograph findings with air fluid level, complete opacity or mucosal thickening greater than 5 mm; or sinus CTs with air-fluid levels, or complete opacity in any sinus.
Participants included in the review
Adults with suspected acute sinusitis in primary care were eligible for inclusion. Studies of children, or where the study population was drawn from specialist practice, were excluded. The included participants were men and women aged between 15 and 79 years with a symptom duration of less than 90 days.
Outcomes assessed in the review
There were no specific inclusion criteria for the outcomes. Likelihood ratios (LRs) and frequencies for various signs and symptoms of purulent sinusitis were reported for the individual studies included in the review. Predictive values for multiple signs and symptoms were also reported. The effects upon clinical decision-making were reported.
How were decisions on the relevance of primary studies made?
The authors did not state how the papers were selected for the review, or how many reviewers performed the selection.