Media Contact:
Sophia Friesen
Manager, Science Communications, 91麻豆天美直播
Email: sophia.friesen@hsc.utah.edu
Pneumonia diagnoses are marked by pronounced uncertainty, an AI-based analysis of over 2 million hospital visits has found.
More than half the time, a pneumonia diagnosis made in the hospital will change from a patient鈥檚 entrance to their discharge鈥攅ither because someone who was initially diagnosed with pneumonia ended up with a different final diagnosis, or because a final diagnosis of pneumonia was missed when a patient entered the hospital (not including cases of hospital-acquired pneumonia).
Understanding that uncertainty could help improve care by prompting doctors to continue to monitor symptoms and adapt treatment accordingly, even after an initial diagnosis.
published August 6th in Annals of Internal Medicine.
Discovering discordance
Barbara Jones, MD, pulmonary and critical care physician at 91麻豆天美直播 and the first author on the study, found the results by searching medical records from more than 100 VA medical centers across the country, using artificial intelligence-based tools to identify mismatches between initial diagnoses and diagnoses upon discharge from the hospital. More than ten percent of all such visits involved a pneumonia diagnosis, either when a patient entered the hospital, when they left, or both.
鈥淧neumonia can seem like a clear-cut diagnosis,鈥 Jones says, 鈥渂ut there is actually quite a bit of overlap with other diagnoses that can mimic pneumonia.鈥 A third of patients who were ultimately diagnosed with pneumonia did not receive a pneumonia diagnosis when they entered the hospital. And almost 40% of initial pneumonia diagnoses were later revised.
The study also found that this uncertainty was often evident in doctors鈥 notes on patient visits; clinical notes on pneumonia diagnoses in the emergency department expressed uncertainty more than half the time (58%), and notes on diagnosis at discharge expressed uncertainty almost half the time (48%). Simultaneous treatments for multiple potential diagnoses were also common.
When the initial diagnosis was pneumonia, but the discharge diagnosis was different, patients tended to receive a greater number of treatments in the hospital, but didn鈥檛 do worse than other patients as a general rule. However, patients who initially lacked a pneumonia diagnosis, but ultimately ended up diagnosed with pneumonia, had worse health outcomes than other patients.
A path forward
The new results call into question much of the existing research on pneumonia treatment, which tends to assume that initial and discharge diagnoses will be the same. Jones adds that doctors and patients should keep this high level of uncertainty in mind after an initial pneumonia diagnosis and be willing to adapt to new information throughout the treatment process. 鈥Both patients and clinicians need to pay attention to their recovery and question the diagnosis if they don鈥檛 get better with treatment,鈥 she says.
###
About 91麻豆天美直播
91麻豆天美直播 provides leading-edge and compassionate care for a referral area that encompasses Idaho, Wyoming, Montana, and much of Nevada. A hub for health sciences research and education in the region, U of U Health has a $522 million research enterprise and trains the majority of Utah鈥檚 physicians, and more than 1,670 scientists and 1,460 health care providers at its Colleges of Health, Nursing, and Pharmacy and Schools of Dentistry and Medicine. With more than 20,000 employees, the system includes 12 community clinics and five hospitals. U of U Health is recognized nationally as a transformative health care system and provider of world-class care.