Are Clinical Findings Reliable in Children with Suspected Community-Acquired Pneumonia?

In a prospective cohort study of children presenting to a pediatric emergency department with signs and symptoms of lower respiratory tract illness (e.g., cough, chest pain, tachypnea, adventitious breath sounds), investigators determined the interrater reliability of examination findings among children who received a chest radiograph. Any two available clinicians (nurse practitioner, pediatric emergency medicine fellow, or emergency department attending) independently evaluated each patient. Although the intention was for clinicians to complete their assessments prior to knowing the patient's radiograph results, 71% of first assessors and 63% of second assessors knew the radiographic findings at the time of assessments.

Assessments were mad…