Pneumonia Clinical Prediction (Heckerling)
Info
Temperature >100°F (>37.8°C) Yes No
Heart rate >100/minute Yes No
Crackles (Rales) Yes No
Decreased breath sounds Yes No
History of asthma Yes No
Setting Patient Being Seen in? Primary Care Emergency Department
R e s u l t s
---
 
Result
 
Show Results
Info
Pneumonia Clinical Prediction (Heckerling)

The Heckerling Clinical Decision Rule for diagnosis of pneumonia is for use in adults with acute respiratory illness, and uses presence or absence of 5 clinical factors to predict that probability of pneumonia being present.

The following items are marked Yes or No

  • Temperature >100°F (>37.8°C)
  • Heart rate >100/minute
  • Crackles (Rales)
  • Decreased breath sounds

Scoring: Each yes item is scored 1 point,

  • History of asthma

Scoring: No =1, Yes=0.

Range of scores from 0-5 points.

Interpretation:

Pretest probability affects the post test probability of pneumonia.In most primary care settings, the pretest probability of pneumonia is 5%, whereas in emergency department settings, the pretest probability is 15%.

In Primary Care Setting:

Score Post test probability of patient having pneumonia (%)
0 1
1 1
2 4
3 8
4 27
5 47


In Emergency Department Setting:

Score Post test probability of patient having pneumonia (%)
0 2
1 3
2 11
3 22
4 56
5 75

Reference:

Ebell MH. Predicting Pneumonia in Adults with Respiratory Illness. Am Fam Phy. 15 August 2007;76(4):560-2.

Heckerling PS, et al. Clinical prediction rule for pulmonary infiltrates. Ann Intern Med. 1990;113:664-70.