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Agreement between emergency physician diagnosis and radiologist reports in patients discharged from an emergency department with community-acquired pneumonia

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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.

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Abbreviations

CAP:

Community-acquired pneumonia

CXR:

Chest X-ray

HRCT:

High-resolution computerized tomography

ED:

Emergency department

EP:

Emergency physician

RR:

Radiology report

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Acknowledgements

The authors wish to thank Corrine Burke of the Department of Emergency medicine, Dalhousie University, Halifax, Nova Scotia, for her help with preparation of the manuscript.

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Authors and Affiliations

  1. Department of Emergency Medicine, Queen Elizabeth II Health Sciences Centre, Dalhousie University, Room 3021, 1796 Summer Street, Halifax, Nova Scotia, Canada, B3H 3A7

    Samuel G. Campbell, Daphne D. Murray, Ammar Hawass, David Urquhart, Stacy Ackroyd-Stolarz & David Maxwell

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  1. Samuel G. Campbell
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  2. Daphne D. Murray
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  3. Ammar Hawass
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  5. Stacy Ackroyd-Stolarz
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  6. David Maxwell
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Correspondence to Samuel G. Campbell.

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Campbell, S.G., Murray, D.D., Hawass, A. et al. Agreement between emergency physician diagnosis and radiologist reports in patients discharged from an emergency department with community-acquired pneumonia. Emerg Radiol 11, 242–246 (2005). https://doi.org/10.1007/s10140-005-0413-4

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  • DOI: https://doi.org/10.1007/s10140-005-0413-4

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