Send to:

Choose Destination
See comment in PubMed Commons below
Pediatr Emerg Care. 2010 Nov;26(11):817-22. doi: 10.1097/PEC.0b013e3181fb0d95.

Physician assessment of the likelihood of pneumonia in a pediatric emergency department.

Author information

  • 1Division of Emergency Medicine, Children's Hospital, Boston, MA 02115, USA.



The value of physical examination findings in the diagnosis of pneumonia in children may be limited, and the accuracy of physicians in predicting pneumonia is not known.


We sought to determine the correlation between physicians' assessment of the likelihood of pneumonia and radiographic presence of pneumonia.


Prospective observational study of children 21 years or younger presenting to a pediatric emergency department, who had a chest radiography performed for suspicion of pneumonia. Physicians recorded clinical findings and likelihood of pneumonia before obtaining the radiograph. Definite and probable pneumonia was defined by a radiologist's interpretation of the radiograph.


Of 2071 children, 147 (7%) had definite radiographic pneumonia, whereas 321 (15%) had probable or definite pneumonia. Among patients perceived to be at lowest risk for pneumonia (<5% prediction), 4.3% (95% confidence interval [CI], 2.9%-5.7%) had definite pneumonia, and 10.0% (95% CI, 8.3%-12.5%) had probable or definite pneumonia. Among children perceived to be at highest risk for pneumonia (>75% prediction), 30.6% (95% CI, 15.5%-45.6%) had definite pneumonia, and 52.8% (95% CI, 37.7%-70.3%) had probable or definite pneumonia. Physicians' estimates of the likelihood of pneumonia were positively correlated with the rate of definite (Spearman ρ = 0.15, P < 0.001) and probable or definite radiographic pneumonia (Spearman ρ = 0.19, P < 0.001).


With some overestimation, physicians' assessment of the likelihood of pneumonia correlates well with radiographic diagnosis of pneumonia.

[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Lippincott Williams & Wilkins
    Loading ...
    Write to the Help Desk