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. 2020 Jul 7;2020(7):CD013665. doi: 10.1002/14651858.CD013665

Rentsch 2020.

Study characteristics
Patient Sampling Purpose: diagnosis SARS‐CoV‐2 test positives
Design: cross‐sectional, retrospective study
Recruitment: electronic health record data from the national Veterans Affairs Healthcare System ‐ national Corporate Data Warehouse (USA)
Sample size: 3789 (585 cases)
Inclusion criteria: all patients in the Veterans Affairs cohort, born between 1945 and 1965 and active in care, tested for COVID‐19 between 8 February and 30 March 2020
Exclusion criteria: patients for whom results were pending (n = 93) or inconclusive (n = 33) were excluded
Patient characteristics and setting Facility cases: tested positive for SARS‐CoV‐2
Facility controls: tested negative for SARS‐CoV‐2
Country: USA
Dates: 8 February 2020‐30 March 2020
Symptoms and severity: all patients who were tested were included
Demographics: median age overall: 65.7 years (IQR 60.5‐70.7) (cases: 66.1 years, controls: 65.6 years);
gender overall (M%/F%): 90.2/9.8, cases 95.4/4.6, controls 89.2/10.8
Exposure history: not specified (all over USA)
Index tests
  • Hypoxia (oxygen saturation ≤ 93%)

  • Body temperature (3 categories)

Target condition and reference standard(s)
  • TC: SARS‐CoV‐2 infection

  • RS: no data on reference PCR test used, multiple different reference tests used with unknown test characteristics (samples: nasopharyngeal swabs)

Flow and timing Time interval maximum 2 days
Comparative  
Notes  
Methodological quality
Item Authors' judgement Risk of bias Applicability concerns
DOMAIN 1: Patient Selection
Was a consecutive or random sample of patients enrolled? Yes    
Was a case‐control design avoided? Yes    
Did the study avoid inappropriate exclusions? Yes    
Did the study avoid inappropriate inclusions? Unclear    
Could the selection of patients have introduced bias?   Low risk  
Are there concerns that the included patients and setting do not match the review question?     Unclear
DOMAIN 2: Index Test (All tests)
Were the index test results interpreted without knowledge of the results of the reference standard? Unclear    
If a threshold was used, was it pre‐specified? Yes    
Could the conduct or interpretation of the index test have introduced bias?   Unclear risk  
Are there concerns that the index test, its conduct, or interpretation differ from the review question?     Low concern
DOMAIN 3: Reference Standard
Is the reference standards likely to correctly classify the target condition? Unclear    
Were the reference standard results interpreted without knowledge of the results of the index tests? Unclear    
Could the reference standard, its conduct, or its interpretation have introduced bias?   Unclear risk  
Are there concerns that the target condition as defined by the reference standard does not match the question?     Low concern
DOMAIN 4: Flow and Timing
Was there an appropriate interval between index test and reference standard? Yes    
Did all patients receive the same reference standard? Unclear    
Were all patients included in the analysis? No    
Could the patient flow have introduced bias?   Low risk