Re: Signs and Symptoms That Rule Out Community-Acquired Pneumonia in Outpatient Adults: A Systematic Review and Meta-Analysis

To the Editor: Dr. Marchello et al¹ make an important contribution to clinical medicine and patient care by creating evidence for how to combine key clinical findings to confidently position the possibility of pneumonia in adults further down in the differential diagnosis in patients with acute respiratory illness. Although their findings seem to ring true from clinical experience, their clinical tool requires prospective validation per the authors.

While most family physicians currently do not have point-of-care ultrasound (POCUS), the majority will in the future. Use of pocket ultrasound is becoming common among medical students, training in family medicine residencies is increasing, and POCUS continued medical education training is very accessible. Point-of-care lung ultrasound (POCLUS) is more reliable than a chest radiograph to rule in or rule out pneumonia in adults and children.^2,3,4,5 The author's suggested future prospective research might also include a research arm to evaluate the potential additive benefit of combining POCLUS with their clinical decision-making tool.

Respectfully submitted,