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Emerg Radiol. 2005 Jun;11(4):242-6.

Agreement between emergency physician diagnosis and radiologist reports in patients discharged from an emergency department with community-acquired pneumonia.

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Department of Emergency Medicine, Queen Elizabeth II Health Sciences Centre, Dalhousie University, 1796 Summer Street, Halifax, Nova Scotia, Canada.


To evaluate the level of concurrence between radiologist reports and the diagnosis of community-acquired pneumonia (CAP) in patients discharged from an emergency department (ED), a retrospective chart audit of patients discharged with a diagnosis of 'pneumonia' or 'possible pneumonia' from the ED during a 2-year period was conducted. Emergency physician (EP) and radiology report (RR) diagnoses were categorized as 'pneumonia', 'possible pneumonia', 'non-pneumonia' and 'normal', and categories from each were compared. 815 charts were analyzed. Of 671 EP diagnoses of 'pneumonia', 304 (45.3%) RR's reported 'pneumonia' and 82 (12.2%), 'possible pneumonia'. Of 815 EP diagnoses of 'pneumonia' or 'possible pneumonia', 426 (52.3%) RRs were in agreement, while 216(26.5%) were of diagnoses other than pneumonia and 173 (21.1%) were read as normal. EPs and radiologists frequently disagree on whether a patient has pneumonia or not. Perhaps it is time to revisit the gold standard status of plain chest X-ray.

[Indexed for MEDLINE]

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