ArticleBMC emergency medicine2026
Diagnostic discordance and differential diagnoses of community-acquired pneumonia in the emergency department.
Article in BMC emergency medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCommunity-acquired pneumonia (CAP) is a common reason for presentation to the emergency department (ED), but accurate diagnosis is challenging due to overlapping and often nonspecific clinical features. Data on the frequency and spectrum of alternative diagnoses in patients initially diagnosed with CAP in the ED are limited. The aim of this study was to evaluate the diagnostic concordance of an initial ED diagnosis of CAP, characterize common alternative discharge diagnoses, and analyze clinical, laboratory, imaging utilization, and vital sign parameters associated with confirmed CAP.
methodsWe conducted a retrospective analysis of diagnostic concordance and differential diagnoses in 1,385 adult patients who presented to the ED of Hannover Medical School and were initially diagnosed with CAP. Initial ED diagnoses were compared with discharge diagnoses.
resultsThe cohort comprised 37% female and 63% male patients with a median age of 71 years (IQR 58-79). Comparison between initial ED and discharge diagnoses demonstrated that suspected CAP was confirmed in 52% (n = 663) of cases. The most common differential diagnoses were other pulmonary conditions (n = 297, 41%), cardiac conditions (n = 150, 21%), and renal conditions (n = 95, 13%). Patients with confirmed CAP showed significantly higher C-reactive protein (CRP) levels (82 mg/L [IQR 37-159] vs. 57 mg/L [IQR 22-127]; p < 0.001) and slightly higher body temperature (37.1 °C [IQR 36.4-38.0] vs. 36.8 °C [IQR 36.2-37.7]; p < 0.001) than those with alternative diagnoses.
conclusionOnly about half of patients initially diagnosed with CAP in the emergency setting had a confirmed diagnosis at discharge, indicating that CAP in this context should be regarded as a working diagnosis rather than a definitive entity. Isolated laboratory, imaging, and vital sign parameters showed limited ability to distinguish CAP from alternative diagnoses, highlighting the importance of structured reassessment after admission to confirm or revise the initial diagnosis and to reduce misclassification and unnecessary antibiotic use.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.