Physical exams may not reliably diagnose pediatric pneumonia

25 Aug 2026, 19:20 · Medical Xpress

by Lori Solomon

Robert Egan

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Clinicians may not agree on physical exam findings for youth with community-acquired pneumonia (CAP), according to a study published online Aug. 20 in JAMA Network Open.

Shubhada Hooli, M.D., from Texas Children's Hospital and Baylor College of Medicine in Houston, and colleagues examined the interrater reliability (IRR) of physical examination findings in youth diagnosed with CAP. The analysis included 252 youth ages 3 months to 17 years with CAP.

The researchers found that no physical examination finding met predefined significance for IRR. The highest IRR was seen for wheezing (κ = 0.50) and retractions (κ = 0.49). IRRs for physical examinations were similar for youth discharged home and those who were hospitalized.

"Doctors rely heavily on what they hear when listening to a child's lungs, but our study shows that two doctors can examine the same child and come away with different findings," senior author Todd Florin, M.D., from Northwestern University Feinberg School of Medicine in Chicago, said in a statement. "This can make diagnosing pneumonia challenging and points to the need for better tools to help us make these decisions."

Publication details

Shubhada Hooli et al, Reliability of Physical Examination Findings in Youths Diagnosed With Pneumonia, JAMA Network Open (2026). DOI: 10.1001/jamanetworkopen.2026.30074

Journal information: JAMA Network Open

Key medical concepts

Community-Acquired PneumoniaWheezings

Clinical categories

PediatricsChildren's healthPulmonary medicineCommon illnesses & Prevention Who's behind this story?

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