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In Reply: In response to Dr Rosenfeld, we agree that the Berg and Carenfelt criteria¹ applied test characteristics are unknown in populations such as the one we studied. He is correct about the differences in study populations, although we think that most of these miss the essence of the sample studied by Berg and Carenfelt. The most prominent features of both studies are that they comprise patients with similarly acute and untreated sinusitis (although we consider it a limitation of the Berg and Carenfelt study that it used a mixed population, including some chronic patients and some treated with antibiotics). We are unaware of any other better published reference test that can be applied at the office visit or primary care setting² where the vast majority of patients are seen and often receive unnecessary antibiotics (>90% prescribed³). Another study found that in the presence of 2 criteria, 82.7% of . . . [Full Text of this Article]

Ian G. Williamson, MD
igw@soton.ac.uk

Michael Moore, FRCGP; Paul Little, MD
Department of Medicine
University of Southampton
Southampton, United Kingdom

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