GrippeCanadaV3, Main, Exploration, bibRecord, 000776

Clinical diagnosis of pneumonia, typical of experts.

Identifieur interne : 000776 ( Main/Exploration ); précédent : 000775; suivant : 000777

Clinical diagnosis of pneumonia, typical of experts.

Auteurs : Olli S. Miettinen [Canada] ; Kenneth M. Flegel ; Johann Steurer

Source :

Journal of evaluation in clinical practice [ 1365-2753 ] ; 2008.

RBID : pubmed:18324941

Descripteurs français

KwdFr :
- Adulte, Adulte d'âge moyen, Algorithmes, Canada, Diagnostic différentiel, Enquêtes et questionnaires, Europe, Expertise, Femelle, Humains, Modèles logistiques, Mâle, Pneumopathie infectieuse (diagnostic), Pneumopathie infectieuse (imagerie diagnostique), Pneumopathie infectieuse (physiopathologie), Radiographie, Sujet âgé, États-Unis d'Amérique.
MESH :
- diagnostic : Pneumopathie infectieuse.
- imagerie diagnostique : Pneumopathie infectieuse.
- physiopathologie : Pneumopathie infectieuse.
- Adulte, Adulte d'âge moyen, Algorithmes, Canada, Diagnostic différentiel, Enquêtes et questionnaires, Europe, Expertise, Femelle, Humains, Modèles logistiques, Mâle, Radiographie, Sujet âgé, États-Unis d'Amérique.

English descriptors

KwdEn :
- Adult, Aged, Algorithms, Canada, Diagnosis, Differential, Europe, Expert Testimony, Female, Humans, Logistic Models, Male, Middle Aged, Pneumonia (diagnosis), Pneumonia (diagnostic imaging), Pneumonia (physiopathology), Radiography, Surveys and Questionnaires, United States.
MESH :
- diagnosis : Pneumonia.
- diagnostic imaging : Pneumonia.
- physiopathology : Pneumonia.
- Adult, Aged, Algorithms, Canada, Diagnosis, Differential, Europe, Expert Testimony, Female, Humans, Logistic Models, Male, Middle Aged, Radiography, Surveys and Questionnaires, United States.

Abstract

BACKGROUND

Clinical diagnosis of pneumonia is a concern when a patient presents with recent cough--new or worsened--together with fever as the chief complaint. Given this presentation, the doctor would benefit from having access to software that specifies, first, what diagnostic indicators experts typically use in that diagnosis; then, upon entry of those facts, what experts' typical probability of pneumonia is in such a case; and finally, how much this probability might change upon adding the facts from chest radiography.

METHODS

We specified a set of 36 hypothetical presentations of this type by patients 20-70 years of age, involving a comprehensive set of clinical-diagnostic indicators. Members of three separate expert panels independently set the probability of pneumonia in each of these cases, and also the range of possible post-radiography probabilities. A logistic function of the diagnostic indicators was fitted to the medians of the probabilities.

RESULTS

The median probability of pneumonia was a joint function of the patient's age and current rate of cigarette smoking; history as to the cough's duration, the fever's maximum, dyspnea (including whether on effort only) and rigors; and physical examination as to temperature, signs of upper respiratory infection, prolongation of expiration, dullness on percussion and some auscultation findings. Non-contributory were history of wheezing, pain on inspiration, type of sputum and signs of cold or influenza. This probability function, and the post-radiography functions based on the same indicators, are accessible at http://www.evimed.ch/pneumonia.

INTERPRETATION

The expert inputs to clinical diagnosis that were derived and made readily accessible provide for expertly clinical diagnosis of pneumonia, relevant for decisions about radiography and treatment without it.

DOI: 10.1111/j.1365-2753.2007.00873.x
PubMed: 18324941

Affiliations:

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Le document en format XML

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<term>Female</term>
<term>Humans</term>
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<term>Diagnostic différentiel</term>
<term>Enquêtes et questionnaires</term>
<term>Europe</term>
<term>Expertise</term>
<term>Femelle</term>
<term>Humains</term>
<term>Modèles logistiques</term>
<term>Mâle</term>
<term>Pneumopathie infectieuse (diagnostic)</term>
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<term>Aged</term>
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<term>Diagnosis, Differential</term>
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<term>United States</term>
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<term>Adulte d'âge moyen</term>
<term>Algorithmes</term>
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<term>Diagnostic différentiel</term>
<term>Enquêtes et questionnaires</term>
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<term>Modèles logistiques</term>
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<front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b>
</p>
<p>Clinical diagnosis of pneumonia is a concern when a patient presents with recent cough--new or worsened--together with fever as the chief complaint. Given this presentation, the doctor would benefit from having access to software that specifies, first, what diagnostic indicators experts typically use in that diagnosis; then, upon entry of those facts, what experts' typical probability of pneumonia is in such a case; and finally, how much this probability might change upon adding the facts from chest radiography.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHODS</b>
</p>
<p>We specified a set of 36 hypothetical presentations of this type by patients 20-70 years of age, involving a comprehensive set of clinical-diagnostic indicators. Members of three separate expert panels independently set the probability of pneumonia in each of these cases, and also the range of possible post-radiography probabilities. A logistic function of the diagnostic indicators was fitted to the medians of the probabilities.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>The median probability of pneumonia was a joint function of the patient's age and current rate of cigarette smoking; history as to the cough's duration, the fever's maximum, dyspnea (including whether on effort only) and rigors; and physical examination as to temperature, signs of upper respiratory infection, prolongation of expiration, dullness on percussion and some auscultation findings. Non-contributory were history of wheezing, pain on inspiration, type of sputum and signs of cold or influenza. This probability function, and the post-radiography functions based on the same indicators, are accessible at http://www.evimed.ch/pneumonia.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>INTERPRETATION</b>
</p>
<p>The expert inputs to clinical diagnosis that were derived and made readily accessible provide for expertly clinical diagnosis of pneumonia, relevant for decisions about radiography and treatment without it.</p>
</div>
</front>
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<AbstractText Label="RESULTS" NlmCategory="RESULTS">The median probability of pneumonia was a joint function of the patient's age and current rate of cigarette smoking; history as to the cough's duration, the fever's maximum, dyspnea (including whether on effort only) and rigors; and physical examination as to temperature, signs of upper respiratory infection, prolongation of expiration, dullness on percussion and some auscultation findings. Non-contributory were history of wheezing, pain on inspiration, type of sputum and signs of cold or influenza. This probability function, and the post-radiography functions based on the same indicators, are accessible at http://www.evimed.ch/pneumonia.</AbstractText>
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Clinical diagnosis of pneumonia, typical of experts.

Clinical diagnosis of pneumonia, typical of experts.

Source :

Descripteurs français

English descriptors

Abstract

Links toward previous steps (curation, corpus...)

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri

Pour générer des pages wiki