Jan 29 (Reuters) – Doctors may miss some cases of pneumonia
if they rely solely on their patient’s medical history and
symptoms without also taking x-rays, according to a European
study.
Dutch researchers, who published their findings in the
European Respiratory Journal, found that of 140 patients who had
their pneumonia diagnosed by x-ray, doctors initially thought
only 41 of them had the severe lung infection.
“That’s worse than flipping a coin,” said Richard Watkins,
who was not involved in the study but has researched how doctors
diagnose pneumonia. “I think that’s an argument for doing chest
x-rays.”
People with pneumonia may have a cough, fever, nausea,
vomiting, chills or chest pain. Under some circumstances, the
infection can put patients into an intensive care unit and even
turn fatal.
In 2009, the U.S. Centers for Disease Control and Prevention
said that about 1.1 million Americans were hospitalized with
pneumonia, and about 50,000 died of it.
According to researchers led by Saskia van Vugt from the
University Medical Center in Utrecht, most doctors use their
best judgment in deciding who has pneumonia, because it’s not
possible to give everyone an x-ray to check for signs of the
infection.
Little was known, however, about how accurate doctors were
with their diagnoses, the researchers wrote.
For the study, van Vugt and her colleagues used information
collected between October 2007 and April 2010 on 2,810 adult
patients of doctors in 12 European countries.
All of the patients came to the doctor with a cough, but
only 72 were initially diagnosed with pneumonia. All of the
patients were then given a chest x-ray to see how accurate the
doctors’ diagnoses were.
Of those 72 initial diagnoses, the x-rays showed that 31 did
not have pneumonia. In the rest of the group, the researchers
found the doctors missed 99 cases.
Overall, the doctors correctly diagnosed fewer than a third
of pneumonia cases.
While catching only 29 percent of pneumonia cases seems
alarming, Watkins said there may be differences between how
doctors Europe and in the United States diagnose the illness.
It’s common, for example, to have U.S. doctors order x-rays if
they suspect pneumonia, he said.
In fact, joint guidelines from the Infectious Diseases
Society of American and American Thoracic Society call for an
x-ray to diagnose pneumonia.
SOURCE: http://bit.ly/WInB55
(Reporting from New York by Andrew Seaman at Reuters Health;
editing by Elaine Lies)
