External validation in 408 patients from the Austin cohort (2002)
Description of validation cohort:
This external validation was performed on the Austin cohort consisting of 408 patients with community-acquired pneumonia. 

Location:
Melbourne, Australia. 

Dates:
January to December 2002. 

Inclusion criteria:
Age ≥18 years, ≥1 symptom of CAP, chest X-ray changes. 

Exclusion criteria:
Admitted with in preceding 14 days, hospital stay <24h, aspiration-active tuberculosis, HIV infected. 

Model performance: 
The AUC in this external validation cohort was 0.81 (95% CI: 0.74-0.88). Corresponding sensitivity and specificity rates were 89% and 46%. The corresponding Hosmer-Lemeshow goodness-of-fit P value was 0.53. 
Research authors: Charles PG, Wolfe R, Whitby M, Fine MJ, Fuller AJ, Stirling R, Wright AA, Ramirez JA, Christiansen KJ, Waterer GW, Pierce RJ, Armstrong JG, Korman TM, Holmes P, Obrosky DS, Peyrani P, Johnson B, Hooy M, Grayson ML, Australian Community-Acquired Pneumonia Study Collaboration
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Discrimination

Rows included 0
C-index 0.81
Brier score Not specified
Scaled Brier score Not specified

Classification plot

Not specified

Calibration

Regression coefficient 0
Intercept 0
Hosmer-Lemeshow GOF Not specified
 

Calibration plot

Not specified

Histogram

Not specified

Decision curve

Not specified
Comparison
Original study population: 882
Validation study population: 408

Categorical characteristics

Name Subset / Group Nr. of patients Validation P-Value
Age ≤50 years 213 Not available
>50 years 669
Gender Male 537 Not available
Female 345
Nursing home resident Yes 55 Not available
No 827
Congestive heart failure Yes 211 Not available
No 671
Cerebrovascular disease Yes 118 Not available
No 764
Malignancy Yes 42 Not available
No 840
Renal impariment Yes 169 Not available
No 713
Liver disease Yes 31 Not available
No 851
Smoking Yes 180 Not available
No 702
Asthma Yes 231 Not available
No 651
COPD Yes 238 Not available
No 644
Alcohol abuse Yes 48 Not available
No 834
Injection drug use Yes 17 Not available
No 865
Diabetes mellitus Yes 159 Not available
No 723
Dementia Yes 73 Not available
No 809
Epilepsy Yes 23 Not available
No 859
Neuromuscular disease Yes 25 Not available
No 857
Immunosuppression Yes 84 Not available
No 798
Antibiotic use before presentation Yes 270 Not available
No 612
Confusion Yes 90 Not available
No 792
Respiratory rate ≥30 breaths/min Yes 195 Not available
No 687
Tachypnea Yes 229 Not available
No 653
Systolic bloodpressure <90 mmHg Yes 47 Not available
No 835
Diastolic bloodpressure ≤60 mmHg Yes 289 Not available
No 593
Pulse ≥125 beats/min Yes 144 Not available
No 738
Pulse oximetry ≤90% Yes 231 Not available
No 651
Arterial pH <7.35 Yes 79 Not available
No 432
PaO2 <60 mmHg Yes 220 Not available
No 291
PaO2/FiO2 <250 Yes 197 Not available
No 314
Hypoxia Yes 406 Not available
No 476
Hematocrit <30% Yes 34 Not available
No 848
WBC count <4 or >15x10^9 cells/L Yes 305 Not available
No 577
ESR >50 Yes 266 Not available
No 315
Sodium level <130 mmol/L Yes 102 Not available
No 780
Urea level >7 mmol/L Yes 380 Not available
No 502
Urea level ≥11 mmol/L Yes 174 Not available
No 708
Glucose level ≥14 mmol/L Yes 47 Not available
No 753
Albumin level <3.5 g/dL Yes 455 Not available
No 398
CRP level >150 mg/L Yes 414 Not available
No 439
Multilobar CXR involvement Yes 101 Not available
No 781
Pleural effusion Yes 147 Not available
No 735
Positive result of Legionella urinary antigen test Yes 19 Not available
No 828
Died in the hospital Yes 41 Not available
No 841
Died within 30 days after admission Yes 40 Not available
No 832
PSI risk class Class I 109 Not available
Class II 139
Class III 160
Class IV 301
Class V 173
CURB-65 score Class I 405 Not available
Class II 238
Class III 239
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