Diagnosing pneumonia in patients with acute cough: clinical judgment compared to chest radiography
| Autor: | Paul Little, Berna D L Broekhuizen, Pim A. de Jong, Herman Goossens, Christopher C Butler, Theo Verheij, Saskia van Vugt, Kerenza Hood, Samuel Coenen |
|---|---|
| Přispěvatelé: | GRACE Project Group |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine Pediatrics medicine.medical_specialty Acute cough Radiography Physical examination Sensitivity and Specificity Judgment General Practitioners Predictive Value of Tests medicine Humans In patient Medical diagnosis Intensive care medicine Physical Examination Aged Primary Health Care medicine.diagnostic_test business.industry Reproducibility of Results Pneumonia Middle Aged medicine.disease Clinical judgment respiratory tract diseases Cough Predictive value of tests Female Radiography Thoracic Human medicine business |
| Zdroj: | The European respiratory journal |
| ISSN: | 0903-1936 |
| Popis: | Pneumonia is often diagnosed and treated empirically. We set out to determine the diagnostic accuracy of clinical judgment based on signs and symptoms to detect radiographic pneumonia in patients presenting with acute cough in primary care. In 2810 European patients with acute cough, general practitioners (GPs) recorded whether they considered pneumonia to be present (yes or no) immediately after history and physical examination. Chest radiography was performed within 1 week by local radiologists blind to other patient characteristics. 140 patients had radiographic pneumonia (5%), of whom 41 (29%) had been diagnosed as such. 31 (1%) patients had a clinical diagnosis that was not confirmed by radiography (n=2670). In clinically suspected pneumonia, 57% of subjects were subsequently diagnosed with radiographic pneumonia. Negative predictive value (NPV), sensitivity and specificity of GPs clinical judgment were 96%, 29% and 99%, respectively. Compared to patients with a clinical diagnosis of pneumonia, less severe symptoms were found in radiographic pneumonia cases not suspected clinically (p |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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