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Clinical Notes
June 2, 1978

Pneumococcal PneumoniaA Misleading Diagnosis for Audit Studies

JAMA. 1978;239(22):2372. doi:10.1001/jama.1978.03280490056027

IN PREPARATION for a joint audit study, four community hospitals reviewed their statistics of patients discharged with a primary diagnosis of pneumonia during the past two calendar years. The total number of discharges was determined for each of the different International Classification of Diseases Adapted (ICDA) codes for pneumonia. In most persons, the cause of the pneumonia was not specified, but there were 48 cases of pneumococcal pneumonia from all hospitals during the two years. This seemed to be an unusually high number of reported cases for a group of small hospitals. Therefore, a special study of pneumococcal pneumonia was conducted along with a general study of pneumonia.

Two screening criteria were used for the pneumococcal pneumonia study, which included (1) abnormal chest roentgenogram, ie, compatible with pneumonia anytime during admission, and (2) positive sputum culture for pneumococci. Of the 48 records coded as a primary discharge diagnosis of pneumococcal

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