@article {Jonesclinmed.2020-0519, author = {Nick K Jones and Isobel Ramsay and Elinor Moore and Jonathan Fuld and Chris Adcock and Edward Banham-Hall and Judith Babar and Effrossyni Gkrania-Klotsas and Hoi Ping Mok}, title = {Admission COVID-19 clinical risk assessment for guiding patient placement and diagnostic testing strategy}, elocation-id = {clinmed.2020-0519}, year = {2021}, doi = {10.7861/clinmed.2020-0519}, publisher = {Royal College of Physicians}, abstract = {Introduction Without universal access to point-of-care SARS-CoV-2 testing, many hospitals rely on clinical judgement alone for identifying cases of COVID-19 early.Methods Cambridge University Hospitals NHS Foundation Trust introduced a {\textquoteleft}traffic light{\textquoteright} clinical judgement aid to the COVID-19 admissions unit in mid-March 2020. Ability to accurately predict COVID-19 was audited retrospectively across different stages of the epidemic.Results One SARS-CoV-2 PCR positive patient (1/41, 2\%) was misallocated to a {\textquoteleft}green{\textquoteright} (non-COVID-19) area during the first period of observation, and no patients (0/32, 0\%) were mislabelled {\textquoteleft}green{\textquoteright} during the second period. 33 of 62 (53\%) labelled {\textquoteleft}red{\textquoteright} (high risk) tested SARS-CoV-2 PCR positive during the first period, while 5 of 22 (23\%) {\textquoteleft}red{\textquoteright} patients were PCR positive in the second.Conclusion COVID-19 clinical risk stratification on initial assessment effectively identifies non-COVID-19 patients. However, diagnosing COVID-19 is challenging and risk of overcalling COVID-19 should be recognised, especially when background prevalence is low.}, issn = {1470-2118}, URL = {https://www.rcpjournals.org/content/early/2021/02/03/clinmed.2020-0519}, eprint = {https://www.rcpjournals.org/content/early/2021/02/03/clinmed.2020-0519.full.pdf}, journal = {Clinical Medicine} }