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Description

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)

 


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