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We appreciate the gracious and insightful comments by Chalmers1 on our recent opinion paper.2 To fully consider the points raised by Chalmers, we decided to calculate the positive and negative likelihood ratio (+LR and –LR, respectively) for several scoring systems, using data from our recently published prospective study of community-acquired pneumonia (CAP) at the Michael E. DeBakey Veteran Affairs Medical Center. The details of this study are published elsewhere.3 Of 191 immunocompetent patients with CAP, 31 (16.2%) were admitted to the intensive care unit (ICU) and/or died within 30 days of admission. The performance of several CAP scores as predictors of a poor outcome (ICU admission and/or 30 day mortality) are shown in Table 1.

Response: Predicting poor outcomes in community-acquired pneumonia: Table 1