GP judgement not enough to accurately diagnose cases of pneumonia

January 23, 2013

Pneumonia cannot be accurately diagnosed solely on a doctor's analysis of symptoms and patient history, according to new findings.

A new study, published online today ahead of print in the , found that a majority of cases could not be accurately diagnosed by a doctor's judgement alone, compared to a chest radiograph.

The major symptoms of pneumonia include acute cough and other symptoms, such as . Most people showing these symptoms are diagnosed with acute bronchitis, and only a minority with pneumonia. These conditions are treated very differently; pneumonia usually requires , whereas acute bronchitis does not. An accurate diagnosis is therefore essential.

Most doctors are required to diagnose pneumonia based on a patient's and , as a chest radiograph is not feasible for every patient who displays these symptoms. However, it is largely unknown how accurate this method of diagnosis is.

To test this method, researchers analysed 2,810 patients across 12 European countries. Each patient had an acute cough and their attending doctor was asked whether pneumonia was present after looking at the patient's signs and symptoms. All patients then received a chest radiograph by a different medical professional.

Out of the total study, 140 patients were diagnosed with pneumonia after a chest radiograph. Out of this group, 29% had been correctly diagnosed by their doctor as having pneumonia. Only 31 patients (1%) were incorrectly diagnosed as having pneumonia from an initial assessment that was later disproved by the chest radiograph. In patients without a doctor's diagnosis of pneumonia, 96% indeed had no pneumonia after chest radiography.

The researchers concluded that doctors accurately excluded pneumonia. However, the majority of radiographically confirmed were not identified.

Lead researcher, Saskia van Vugt, from Utrecht Julius Center for Health Sciences and Primary Care, in the Netherlands, said: "The results of the study are encouraging to some extent as the findings might support physicians to rely more on their ability to correctly exclude pneumonia which might result in better targeted antibiotic prescriptions. However, a majority of the pneumonia cases in this study were not picked up by an initial assessment alone.

"Tests that could support a doctor's ability to detect or exclude pneumonia are urgently needed. We should also remember that GPs tell patients to revisit them if symptoms get worse or persist, as a 'safety net' for initially missed cases.

More information: Diagnosing pneumonia in patients with acute cough: clinical judgment compared to chest radiography, SF van Vugt, Th JM Verheij, PA de Jong, CC Butler, K Hood, S Coenen, H Goossens, P Little, BDL Broekhuizen, on behalf of the GRACE Project Group, DOI: 10.1183/09031936.00111012

Related Stories

Glucose levels at admission predict death in pneumonia

May 30, 2012

(HealthDay) -- For patients with community-acquired pneumonia without preexisting diabetes, serum glucose levels at admission are predictive of death at 28 and 90 days, according to a study published online May 29 in BMJ.

Recommended for you

Experimental MERS vaccine shows promise in animal studies

July 28, 2015

A two-step regimen of experimental vaccines against Middle East respiratory syndrome (MERS) prompted immune responses in mice and rhesus macaques, report National Institutes of Health scientists who designed the vaccines. ...

Can social isolation fuel epidemics?

July 21, 2015

Conventional wisdom has it that the more people stay within their own social groups and avoid others, the less likely it is small disease outbreaks turn into full-blown epidemics. But the conventional wisdom is wrong, according ...

Lack of knowledge on animal disease leaves humans at risk

July 20, 2015

Researchers from the University of Sydney have painted the most detailed picture to date of major infectious diseases shared between wildlife and livestock, and found a huge gap in knowledge about diseases which could spread ...

IBD genetically similar in Europeans and non-Europeans

July 20, 2015

The first genetic study of inflammatory bowel disease (IBD) to include individuals from diverse populations has shown that the regions of the genome underlying the disease are consistent around the world. This study, conducted ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.