Diagnostic and Prognostic Testing in Pneumonia
Authors: Bernard M. Karnath, Join Y. Luh
Journal: Annals of Internal Medicine (2003)

Letters2 December 2003Diagnostic and Prognostic Testing in PneumoniaBernard M. Karnath, MD and Join Y. Luh, MDBernard M. Karnath, MDFrom The University of Texas Medical Branch at Galveston, Galveston, TX 77555-1173.Search for more papers by this author and Join Y. Luh, MDFrom The University of Texas Medical Branch at Galveston, Galveston, TX 77555-1173.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-139-11-200312020-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Metlay and Fine systematically reviewed characteristics of the history, physical examination, and laboratory findings in the diagnosis of community-acquired pneumonia (1). We are most concerned about their statement that the history and physical examination cannot provide a high level of certainty in the diagnosis of community-acquired pneumonia (1). Specifically, the physical examination was not sufficiently accurate in the diagnosis of pneumonia, a finding supported by other studies as well (2). The lack of influence of positive chest examination findings in the diagnosis of community-acquired pneumonia is further compounded by poor interobserver agreement among chest findings common to ...References1. Metlay JP, Fine MJ. Testing strategies in the initial management of patients with community-acquired pneumonia. Ann Intern Med. 2003;138:109-18. [PMID: 12529093] LinkGoogle Scholar2. Wipf JE, Lipsky BA, Hirschmann JV, Boyko EJ, Takasugi J, Peugeot RL, . Diagnosing pneumonia by physical examination: relevant or relic? Arch Intern Med. 1999;159:1082-7. [PMID: 10335685] CrossrefMedlineGoogle Scholar3. Spiteri MA, Cook DG, Clarke SW. Reliability of eliciting physical signs in examination of the chest. Lancet. 1988;1:873-5. [PMID: 2895374] CrossrefMedlineGoogle Scholar4. Mangione S, Nieman LZ. Pulmonary auscultatory skills during training in internal medicine and family practice. Am J Respir Crit Care Med. 1999;159:1119-24. [PMID: 10194155] CrossrefMedlineGoogle Scholar5. Mangione S. The teaching of chest auscultation in U.S. internal medicine and family practice medicine residencies. Acad Med. 1999;74:S90-2. [PMID: 10536604] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From The University of Texas Medical Branch at Galveston, Galveston, TX 77555-1173. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTesting Strategies in the Initial Management of Patients with Community-Acquired Pneumonia Joshua P. Metlay and Michael J. Fine Diagnostic and Prognostic Testing in Pneumonia Joshua P. Metlay and Michael J. Fine Metrics 2 December 2003Volume 139, Issue 11Page: 955KeywordsGraduate medical educationPneumoniaResearch laboratoriesSystematic reviewsThoraxUndergraduates ePublished: 2 December 2003 Issue Published: 2 December 2003 CopyrightCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...