Melbye et al evaluated signs and symptoms used to make the clinical diagnosis of pneumonia in relation to the radiographic diagnosis. Clinicians may over- or underweight specific findings. The authors are from the University of Tromso in Norway.
Patient selection: adult with pneumonia
Sign or Symptom
Actual Weight for Logistic Regression
fever AND duration of illness >= 1 week
4.7
coryza
-4.5
sore throat
-2.1
very annoying dyspnea
5
strong, lateral chest pain
8.2
crackles
0.9
Chest findings associated with pneumonia:
(1) crackles with or without wheezes (likelihood ratio 3.7)
(2) pleural rubs (likelihood ratio 6.4)
(3) decreased breath sounds (likelihood ratio 3.2)
(4) dullness to percussion (likelihood ratio 4.0)
While these findings were specific (specificity over 0.9) they had low sensitivity (0.10 to 0.35).
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