'Decline' in Pneumonia Reflects Changes in Diagnostic Coding

"This study highlights the importance of understanding nuances and vagaries of administrative data to evaluate trends over time or compare clinician performance," said Mary S. Vaughan Sarrazin, Ph.D., and Dr. Gary E. Rosenthal.

"These issues go beyond pneumonia and may have affected many studies based on administrative data," including well-publicized studies that reported marked declines in inpatient mortality for congestive heart failure (a 49% decrease), acute MI (a 36% decrease), and stroke (a 26% decrease), they noted.

Dr. Sarrazin and Dr. Rosenthal are with the Center for Comprehensive Access and Delivery Research Evaluation, the Iowa City VA Medical Center, and the University of Iowa Hospitals and Clinics, all in Iowa City. They reported no financial conflicts of interest. These remarks were taken from their editorial accompanying Dr. Lindenauer’s report (JAMA 2012;307:1433-4).