title: Respiratory rate and signs in roentgenographically confirmed pneumonia among children in China.
abstract: A clinical study was conducted in three Chinese community hospitals to investigate the reliability of respiratory rate and various clinical signs in the diagnosis of pneumonia among 54 children less than 5 years of age. Anteroposterior chest film was used as the diagnostic standard. The cutoff criterion for rapid breathing was 50 breaths/minute for infants ages 2 to 11 months and 40/minute in children 1 to 5 years old. Rapid breathing was a better predictor of pneumonia than rales (positive predictive values of 74.5 and 66.9%). Nasal flaring, chest indrawing, stridor and cyanosis of the tongue had predictive values of > 86%, but these clinical signs were observed in only a small proportion of patients. We recommend that village health workers use rapid breathing for diagnosis of pneumonia, rather than auscultation which is difficult and has proved unreliable. Sensitivity, specificity and positive and negative predictive values are presented for seven signs and symptoms of pneumonia.
authors.affiliation: Capital Institute of Pediatrics, Beijing, People's Republic of China.
authors.forename: Y
authors.initials: Y
authors.lastname: Dai
authors.forename: H M
authors.initials: HM
authors.lastname: Foy
authors.forename: Z
authors.initials: Z
authors.lastname: Zhu
authors.forename: B
authors.initials: B
authors.lastname: Chen
authors.forename: F
authors.initials: F
authors.lastname: Tong
mesh_terms: D001314:Auscultation / Q000379:methods; D002675:Child, Preschool; D002681:China; D003490:Cyanosis / Q000209:etiology; D006801:Humans; D007223:Infant; D011014:Pneumonia / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D011859:Radiography; D012119:Respiration; D012129:Respiratory Function Tests; D012680:Sensitivity and Specificity; D014059:Tongue