ArticleJournal of thoracic disease2017
Discordance of physician clinical judgment
Article in Journal of thoracic disease, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Diagnostic accuracy of SMART-COP Score for predicting the need of intensive respiratory and vasopressor support in adults with community-acquired pneumonia-Study from a low resource tertiary care center.Pakistan journal of medical sciences · 2026Article
- Exploration of the correlation between clinical indicators and prognosis in hospitalized children with pneumonia and construction of a risk prediction model based on machine learning algorithms.Frontiers in medicine · 2026Article
- Context factors in clinical decision-making: a scoping review.BMC medical informatics and decision making · 2025Article
- Emergency planned re-infusion therapy and hospitalisation for community-acquired pneumonia: a retrospective case-control study.Journal of global health · 2025Article
- The social experience of uncertainty: a qualitative analysis of emergency department care for suspected pneumonia for the design of decision support.BMC medical informatics and decision making · 2024Article
- Reduction in Hospital Admissions for COPD Exacerbation During the Covid-19 Pandemic.Open respiratory archivesArticle
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundThe relationship between clinical judgment and the pneumonia severity index (PSI) score in deciding the site of care for patients with community-acquired pneumonia (CAP) has not been well investigated. The objective of the study was to determine the clinical factors that influence decision-making to hospitalize low-risk patients (PSI ≤2) with CAP.
methodsAn observational, prospective, multicenter study of consecutive CAP patients was performed at five hospitals in Spain. Patients admitted with CAP and a PSI ≤2 were identified. Admitting physicians completed a patient-specific survey to identify the clinical factors influencing the decision to admit a patient. The reason for admission was categorized into 1 of 6 categories. We also assessed whether the reason for admission was associated with poorer clinical outcomes [intensive care unit (ICU) admission, 30-day mortality or readmission].
resultsOne hundred and fifty-five hospitalized patients were enrolled. Two or more reasons for admission were seen in 94 patients (60.6%), including abnormal clinical test results (60%), signs of clinical deterioration (43.2%), comorbid conditions (28.4%), psychosocial factors (28.4%), suspected H1N1 pneumonia (20.6%), and recent visit to the emergency department (ED) in the past 2 weeks (7.7%). Signs of clinical deterioration and abnormal clinical test results were associated with poorer clinical outcomes (P<0.005).
conclusionsLow-risk patients with CAP and a PSI ≤2 are admitted to the hospital for multiple reasons. Abnormal clinical test results and signs of clinical deterioration are two specific reasons for admission that are associated with poorer clinical outcomes in low risk CAP patients.
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