ArticleJournal of clinical medicine2019
Rational Use of CT-Scan for the Diagnosis of Pneumonia: Comparative Accuracy of Different Strategies.
Article in Journal of clinical medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Factors Associated with 30-Day Non-Return to Pre-Hospital Residence in Older Patients Hospitalized with Pneumonia or Lower Respiratory Tract Infection: The Role of Serum Albumin and Early Treatment Failure.Geriatrics (Basel, Switzerland) · 2026Article
- Treatment failure in suspected community-acquired pneumonia revealing a pulmonary abscess.SAGE open medical case reports · 2026Article
- Evaluating the utility of chest x-rays for non-traumatic chest pain in Australia- a retrospective cohort study.Emergency radiology · 2025Article
- Diagnostic Approach for Accurate Diagnosis of COVID-19 Employing Deep Learning and Transfer Learning Techniques through Chest X-ray Images Clinical Data in E-Healthcare.Sensors (Basel, Switzerland) · 2021Article
- Tailoring glucocorticoids in patients with severe COVID-19: a narrative review.Annals of translational medicine · 2021Review
- Understanding the Host in the Management of Pneumonia. An Official American Thoracic Society Workshop Report.Annals of the American Thoracic Society · 2021Article
- Clinical Applicable AI System Based on Deep Learning Algorithm for Differentiation of Pulmonary Infectious Disease.Frontiers in medicine · 2021Article
- A Rapid, Accurate and Machine-Agnostic Segmentation and Quantification Method for CT-Based COVID-19 Diagnosis.IEEE transactions on medical imaging · 2020Article
- Observational
- COVID-19 Detection Through Transfer Learning Using Multimodal Imaging Data.IEEE access : practical innovations, open solutions · 2020Article
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Diagnosing pneumonia in emergency departments is challenging because the accuracy of symptoms, signs and laboratory tests is limited. As a confirmation test, chest X-ray has significant limitations and is outperformed by CT-scan. However, obtaining a CT-scan in all cases of suspected pneumonia has significant drawbacks. We used a cohort of 200 consecutive elderly patients admitted to the hospital for suspected pneumonia to build a simple prediction score, which was used to determine indication for performing a CT-scan. The reference diagnosis was adjudicated by experts considering all available data, including evolution until discharge and CT scan in all patients. Results were externally validated in a second cohort of 319 patients. Pneumonia was confirmed in 133 patients (67%). Area under the receiver operator curve (AUROC) of physician evaluation was 0.55 (0.46-0.64). The score incorporated four variables independently predicting confirmed pneumonia: male gender, acute cough, C-reactive protein >70 mg/L, and urea <7 mmol/L. AUROC of the score was 0.68 (95% confidence interval (CI) 0.60-0.76). When a CT-scan was obtained for patients at low or intermediate predicted risk (108 patients, 54% of the cohort), AUROC was 0.71 (0.63-0.80) and 0.69 (0.64-0.74) in the derivation and validation cohort, respectively. A simple prediction score for pneumonia had moderate accuracy and could guide the performance of a CT-scan.
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