Over half of pneumonia sufferers face diagnostic uncertainty, examine finds

A nationwide cohort examine representing greater than 2 million affected person encounters discovered that greater than half of all sufferers hospitalized and handled for pneumonia skilled discordant diagnoses from preliminary presentation to discharge.

The analysis highlights a big prevalence of remedy for different diagnoses and frequent expressions of diagnostic uncertainty, underscoring the crucial want for recognizing and addressing diagnostic uncertainty in pneumonia-related care practices.

The authors recommend that these findings name for enhanced consideration to the diagnostic course of and analysis that acknowledges uncertainty to enhance affected person outcomes in pneumonia remedy. That is vital as a result of pneumonia is the main reason for dying from an infection. The examine is revealed in Annals of Inner Medication.

Researchers from the College of Utah and Salt Lake Metropolis VA Healthcare System used administrative information and pure language processing to check the accuracy of pneumonia diagnoses amongst over 2 million admissions to Veterans Administration hospitals between 2015 and 2022.

To discover the change in a pneumonia prognosis throughout a hospitalization, the researchers labeled every hospitalization in line with concordance or discordance in pneumonia diagnoses between three states: preliminary prognosis made within the ED, preliminary chest picture experiences, and discharge. They then measured the concordance of the admission prognosis of pneumonia, a radiographic discovering in keeping with pneumonia, and a discharge prognosis of pneumonia.

They discovered that 36% of sufferers had an admitting prognosis of pneumonia however no discharge prognosis, and 33% had a discharge prognosis of pneumonia however not an admission prognosis. Discordance between a prognosis of pneumonia and chest radiograph findings was additionally frequent.

An accompanying editorial from the College of Connecticut College of Medication says that clinicians settle for diagnostic uncertainty in pneumonia as a result of treating all prospects has not been proven to be inferior to any obtainable different. Whereas CT for all sufferers with suspected pneumonia could enhance accuracy, it nonetheless would unlikely change the remedy, as pneumonia signs and remedy overlap with a number of different situations, together with coronary heart failure and COPD.

The creator agrees that extra analysis is required and means that research ought to quantify the extent of hurt associated to an incorrect prognosis of pneumonia, as doing so would higher outline the extent of significance of interventions to deal with the problem.