A discriminative score was develop by Diehr et al to be used in assessing outpatients presenting with acute cough for pneumonia as indicated by an acute infiltrate in the chest X-ray.
|
Clinical Finding |
Points |
|
rhinorrhea |
-2 |
|
sore throat |
-1 |
|
night sweats |
1 |
|
myalgias |
1 |
|
sputum all day |
1 |
|
respiratory rate > 25 breaths/minute |
2 |
|
temperature >= 37.8°C (100°F) |
2 |
discriminatory score =
= SUM(all points present)
Interpretation:
• minimum score: -3
• maximum score: 7
• The higher the score, the greater the specificity for pneumonia, but the lower the sensitivity.
|
Cutoff score for pneumonia |
Cumulative Sensitivity |
Cumulative Specificity |
|
>= -3 indicates pneumonia |
100% |
8% |
|
>= -2 indicates pneumonia |
91% |
40% |
|
>= -1 indicates pneumonia |
74% |
70% |
|
>= 0 indicates pneumonia |
59% |
88% |
|
>= +1 indicates pneumonia |
33% |
96% |
|
>= +2 indicates pneumonia |
20% |
99% |
|
>= +3 indicates pneumonia |
11% |
99% |
|
>= +4 indicates pneumonia |
<= 4% |
100% |
(Table 5 page 220, Diehr 1984)
|
Cutoff score for pneumonia |
LR(+) |
LR(-) |
|
>= -1 indicates pneumonia |
1.50 |
0.22 |
|
>= +1 indicates pneumonia |
5.0 |
0.47 |
|
>= +3 indicates pneumonia |
14.0 |
0.82 |
(Table 4 page 1444, Metlay 1997)
Specialty: Infectious Diseases, Pulmonology
ICD-10: ,
