Van Vugt et al evaluated patients in primary care with an acute cough for evidence of pneumonia. They developed models for identifying a patient who may additional studies. The authors are from University Medical Center Utrecht, University of Antwerp, Cardiff University and University of Southhampton.
Patient selection: adult with acute cough
Outcome: pneumonia
Parameters:
(1) runny nose
(2) breathlessness
(3) vesicular breathing
(4) pulse in beats per minute
(5) temperature in °C
(6) serum CRP in mg/L
Parameter
Finding
Points
runny nose
no
1
yes
0
breathlessness
no
0
yes
1
vesicular breathing
normal or increased
0
diminished
1
pulse
<= 100 per minute
0
> 100 per minute
1
temperature
<= 37.8°C
0
> 37.8°C (fever)
1
serum CRP
<= 30 mg/L
0
> 30 mg/L
1
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• The higher the score the greater the risk of pneumonia.
Score
Risk Category
Observed Prevalence of Pneumonia
0
low
0.7%
1 or 2
intermediate
3.8%
3 to 6
high
18.2%
Performance:
• The area under the ROC curve was 0.77
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