Dx accuracy for CAP

Robert M Centor rcentor at UAB.EDU
Tue Nov 19 12:43:01 UTC 2013

My pet peeve as an academic hospitalist is the “diagnosis” of CAP (community acquired pneumonia).  Once I hear that phrase I immediately become skeptical.  CAP has seemingly become a waste basket diagnosis for dyspnea and an abnormal CXR.  I love collecting  and presenting patient stories that start as community acquired pneumonia.  In preparing to more formally study this topic, I have spent much time thinking about the problem.   Just yesterday I recalled this paper.  I have not seen it in the diagnostic error literature previously, and thought I would share it with the group.  If you know of other similar articles, I would greatly appreciate the references.

Given the lower diagnostic accuracy on CAP, I urge all physicians to be skeptical of the diagnosis, until collecting appropriate clinical information to support the diagnosis.

http://archinte.jamanetwork.com/article.aspx?articleid=413982 (article available for free)

1. Welker JA, Huston M, McCue JD. Antibiotic timing and errors in diagnosing pneumonia. Arch Intern Med. 2008 Feb 25;168(4):351–6.

Robert M Centor, MD, FACP

Regional Dean, UAB Huntsville Regional Medical Campus
301 Governors Drive
Huntsville, AL 35801

Office: 256-539-7757
Fax: 256-551-4451

Chair-Elect, ACP Board of Regents

Professor, General Internal Medicine
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Birmingham, AL 35294-3407
Office: 205-975-4889

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