Skip to main content

Main menu

  • HOME
  • ARTICLES
    • Current Issue
    • Ahead of Print
    • Archives
    • Abstracts In Press
    • Special Issue Archive
    • Subject Collections
  • INFO FOR
    • Authors
    • Reviewers
    • Call For Papers
    • Subscribers
    • Advertisers
  • SUBMIT
    • Manuscript
    • Peer Review
  • ABOUT
    • The JABFM
    • Editorial Board
    • Indexing
    • Editors' Blog
  • CLASSIFIEDS
  • Other Publications
    • abfm

User menu

Search

  • Advanced search
American Board of Family Medicine
  • Other Publications
    • abfm
American Board of Family Medicine

American Board of Family Medicine

Advanced Search

  • HOME
  • ARTICLES
    • Current Issue
    • Ahead of Print
    • Archives
    • Abstracts In Press
    • Special Issue Archive
    • Subject Collections
  • INFO FOR
    • Authors
    • Reviewers
    • Call For Papers
    • Subscribers
    • Advertisers
  • SUBMIT
    • Manuscript
    • Peer Review
  • ABOUT
    • The JABFM
    • Editorial Board
    • Indexing
    • Editors' Blog
  • CLASSIFIEDS
  • JABFM On Twitter
  • JABFM On YouTube
  • JABFM On Facebook
ReplyCorrespondence

Response: Re: Clinical Diagnosis of Bordetella Pertussis Infection: A Systematic Review

Mark H. Ebell
The Journal of the American Board of Family Medicine September 2017, 30 (5) 682; DOI: https://doi.org/10.3122/jabfm.2017.05.170318
Mark H. Ebell
Department of Epidemiology and Biostatistics University of Georgia, Athens, GA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: ebell@uga.edu
  • Article
  • References
  • Info & Metrics
  • PDF
Loading

To the Editor: We thank Dr. Poddighi for his thoughtful commentary on our article regarding the clinical diagnosis of pertussis.1 We fully agree that the overall clinical impression, sometimes called “clinical gestalt,” is a vital diagnostic tool for many conditions. In fact, we are in the process of performing a systematic review of clinical gestalt for the diagnosis of a range of respiratory infections; we hope that study will shed more light on its accuracy.

Well-validated clinical decision rules (CDRs) can be very useful to support a physician's clinical gestalt. Of course, it is important to remember that CDRs are clinical decision support tools, not decision replacement tools. They must always be applied in the full context of what is known about a patient. For example, a Centor Score in the range of low or moderate probability will be interpreted differently if the clinician knows that a household member had been diagnosed with streptococcal pharyngitis the previous week. CDRs can also help physicians, especially those in training, learn what is important in a history and physical examination and what is not, even if they only integrate these signs and symptoms implicitly (ie, clinical gestalt) rather than explicitly using a CDR.

Finally, we fully agree with Dr. Poddighi's advice to always consider pertussis in the differential diagnosis of a patient with prolonged cough or typical signs and symptoms, such as the characteristic whoop, paroxysmal cough, or posttussive retching or vomiting. A previous systematic review by our research group showed that nearly 1 in 5 children with prolonged cough have pertussis.2

Notes

  • The above letter was referred to the author of the article in question, who offers the following reply.

References

  1. 1.↵
    1. Ebell MH,
    2. Marchello C,
    3. Callahan M
    . Clinical diagnosis of bordetella pertussis infection: a systematic review. J Am Board Fam Med 2017;30:308–19.
    OpenUrlAbstract/FREE Full Text
  2. 2.↵
    1. Marchello C,
    2. Perry A,
    3. Thai T,
    4. Han DS,
    5. Ebell MH
    . Prevalence of atypical pathogens in patients with cough and community-acquired pneumonia: a meta-analysis. Ann Fam Med 2016;14:552–66.
    OpenUrlAbstract/FREE Full Text
PreviousNext
Back to top

In this issue

The Journal of the American Board of Family     Medicine: 30 (5)
The Journal of the American Board of Family Medicine
Vol. 30, Issue 5
September-October 2017
  • Table of Contents
  • Table of Contents (PDF)
  • Cover (PDF)
  • Index by author
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on American Board of Family Medicine.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Response: Re: Clinical Diagnosis of Bordetella Pertussis Infection: A Systematic Review
(Your Name) has sent you a message from American Board of Family Medicine
(Your Name) thought you would like to see the American Board of Family Medicine web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
1 + 3 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Citation Tools
Response: Re: Clinical Diagnosis of Bordetella Pertussis Infection: A Systematic Review
Mark H. Ebell
The Journal of the American Board of Family Medicine Sep 2017, 30 (5) 682; DOI: 10.3122/jabfm.2017.05.170318

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Response: Re: Clinical Diagnosis of Bordetella Pertussis Infection: A Systematic Review
Mark H. Ebell
The Journal of the American Board of Family Medicine Sep 2017, 30 (5) 682; DOI: 10.3122/jabfm.2017.05.170318
Reddit logo Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Notes
    • References
  • Info & Metrics
  • References
  • PDF

Related Articles

  • No related articles found.
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • An Approach to Hair Loss in Hijab-Wearing Individuals in Primary Care
  • Re: Impact of Geodemographic Factors on Antibiotic Prescribing for Acute, Uncomplicated Bronchitis or Upper Respiratory Tract Infection
  • Response: Re: Blood Pressure Checks for Diagnosing Hypertension: Health Professionals' Knowledge, Beliefs, and Practice
Show more Correspondence

Similar Articles

Navigate

  • Home
  • Current Issue
  • Past Issues

Authors & Reviewers

  • Info For Authors
  • Info For Reviewers
  • Submit A Manuscript/Review

Other Services

  • Get Email Alerts
  • Classifieds
  • Reprints and Permissions

Other Resources

  • Forms
  • Contact Us
  • ABFM News

© 2023 American Board of Family Medicine

Powered by HighWire