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Computed tomography (CT) is more sensitive and specific than chest x-ray (CXR) in identifying pneumonic infiltrates in patients with suspected pneumonia. To compare these two imaging modalities, clinicians in four emergency departments (EDs) in France performed both CXR and chest CT in 308 adults with suspected community-acquired pneumonia.
Infiltrates were noted on CXR in 188 patients; CT excluded pneumonia in 56 of these patients. Conversely, 120 patients had no infiltrates on CXR, but CT identified pneumonic infiltrates in 40 of them. Thus, according to CT results, nearly a third of positive CXRs were false positives, and one third of negative CXRs were false negatives. ED physicians rated the probability of pneumonia both before and afte…