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
No History of asthma Yes No
Setting Patient Being Seen in? Primary Care Emergency Department
R e s u l t s
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Output
 
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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
  • No history of asthma

Scoring:

  • Each yes item is scored 1 point, with a range of scores from 0-5 points.

Interpretation:

  • Pretest probability affects the posttest 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 Posttest probability of patient having pneumonia (%)
0 1
1 1
2 4
3 8
4 27
5 47

In Emergency Department Setting:

Score Posttest 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 Physician. 2007;76(4):560-2.
  • Heckerling PS, Tape TG, Wigton RS, et al. Clinical prediction rule for pulmonary infiltrates. Ann Intern Med. 1990;113(9):664-70.