TY - JOUR T1 - Low-dose CT for the diagnosis of pneumonia in elderly patients: a prospective, interventional cohort study JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.02375-2017 SP - 1702375 AU - Virginie Prendki AU - Max Scheffler AU - Benedikt Huttner AU - Nicolas Garin AU - François Herrmann AU - Jean-Paul Janssens AU - Christophe Marti AU - Sebastian Carballo AU - Xavier Roux AU - Christine Serratrice AU - Jacques Serratrice AU - Thomas Agoritsas AU - Christoph Becker AU - Laurent Kaiser AU - Sarah Rosset-Zufferey AU - Valérie Soulier AU - Arnaud Perrier AU - Jean-Luc Reny AU - Xavier Montet AU - Jérôme Stirnemann Y1 - 2018/01/01 UR - http://erj.ersjournals.com/content/early/2018/04/05/13993003.02375-2017.abstract N2 - The diagnosis of pneumonia is challenging. Our objective was to assess whether a low-dose computed tomography (LDCT) modified the probability of diagnosing pneumonia in elderly patients.We prospectively included patients aged over 65 years, with a suspicion of pneumonia treated with antimicrobial therapy. All patients had a chest radiograph and LDCT within 72 h of inclusion. The treating clinician assessed the probability of pneumonia before and after the LDCT by using a Likert scale. An adjudication committee retrospectively rated the probability of pneumonia and was considered as reference for diagnosis. The main outcome was the difference in the clinician's pneumonia probability estimates before and after LDCT and the proportion of modified diagnoses which matched the reference diagnosis (net reclassification improvement (NRI)).200 patients with a median age of 84 years were included. After LDCT, the estimated probability of pneumonia changed in 90 (45%) patients: 60 (30%) were downgraded, 30 (15%) upgraded. The NRI was 8% (NRI event -6% + NRI non event 14%).LDCT modified the estimated probability of pneumonia in a substantial proportion of patients. It mostly helped to exclude a diagnosis of pneumonia and hence to reduce unnecessary antimicrobial therapy.Low-dose CT modified the estimated probability of pneumonia in a substantial proportion of elderly patients (45%)FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Virginie Prendki has nothing to declare.Conflict of interest: Dr. Huttner has nothing to disclose.Conflict of interest: Dr. Garin has nothing to disclose.Conflict of interest: Dr. Herrmann has nothing to disclose.Conflict of interest: No conflict of interest regarding this manuscriptConflict of interest: Dr. Marti has nothing to disclose.Conflict of interest: Christoph BeckerConflict of interest: Dr. roux has nothing to disclose.Conflict of interest: NONEConflict of interest: Dr. Agoritsas has nothing to disclose.Conflict of interest: Dr. Rosset-Zufferey has nothing to disclose.Conflict of interest: I disclose non conflict of interestConflict of interest: Laurent KaiserConflict of interest: I declare no conflict of interestConflict of interest: Dr. Stirnemann has nothing to disclose.Conflict of interest: Dr. Serratrice has nothing to disclose.Conflict of interest: Dr. Scheffler has nothing to disclose. ER -