How accurate is the clinical diagnosis of pneumonia?
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No element or combination of elements from the clinical history and physical examination are sufficiently sensitive or specific to confirm or exclude acute community-acquired pneumonia (CAP). A chest x-ray is recommended to make the diagnosis (Grade of Recommendation: A, based on well-designed cohort studies). No studies specifically demonstrate improved patient outcomes through use of chest x-ray in adults; however, accurate diagnosis is expected to reduce the number of unnecessary antibiotic prescriptions (Grade of Recommendation: D, based on expert opinion).
Clinical Inquiries, 2003 (MU)