title: Agreement between emergency physician diagnosis and radiologist reports in patients discharged from an emergency department with community-acquired pneumonia.
abstract: 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.
authors.affiliation: Department of Emergency Medicine, Queen Elizabeth II Health Sciences Centre, Dalhousie University, 1796 Summer Street, Halifax, Nova Scotia, Canada. samuel.campbell@cdha.nshealth.ca
authors.forename: Samuel G
authors.initials: SG
authors.lastname: Campbell
authors.forename: Daphne D
authors.initials: DD
authors.lastname: Murray
authors.forename: Ammar
authors.initials: A
authors.lastname: Hawass
authors.forename: David
authors.initials: D
authors.lastname: Urquhart
authors.forename: Stacy
authors.initials: S
authors.lastname: Ackroyd-Stolarz
authors.forename: David
authors.initials: D
authors.lastname: Maxwell
mesh_terms: D002983:Clinical Competence; D017714:Community-Acquired Infections / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D010351:Patient Discharge / Q000706:statistics & numerical data; D011014:Pneumonia / Q000000981:diagnostic imaging*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011859:Radiography; D012189:Retrospective Studies