According to a study in the Annals of Internal Medicine, pneumonia diagnoses made in emergency departments (EDs) and hospitals show particular swings in diagnostic uncertainty. Researchers found that in 57% of patients hospitalized for pneumonia in 118 Veterans Affairs hospitals, the diagnosis of pneumonia changed one way or the other between initial presentation and discharge. Of the patients who were initially diagnosed with pneumonia, 36% did not have a pneumonia diagnosis when discharged. Clinical notes, diagnostic codes, testing, and treatment delivery also revealed patterns of diagnostic uncertainty among the 2 million visits studied, the authors found.
Outcomes to consider: Pneumonia symptoms can present similarly to and overlap with other conditions such as chronic obstructive pulmonary disease and asthma. The authors note a missed pneumonia diagnosis at ED presentation was of greater concern because those patients demonstrated worse health outcomes than other patients.
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