Discordant diagnoses occur in more than half of patients hospitalized and treated for pneumonia, according to a study published in Annals of Internal Medicine. Barbara E. Jones, MD, and colleagues examined pneumonia diagnoses among patients hospitalized from the ED. Of 2.38 million hospitalizations, 13.3% received an initial or discharge diagnosis and treatment of pneumonia; 9.1% and 10.0% received an initial and a discharge diagnosis, respectively. In 57% of patients, there was discordance seen between initial and discharge diagnoses, and 33% of those discharged with pneumonia diagnosis and positive initial chest image lacked an initial diagnosis. Further, 36% of those discharged initially lacked a discharge diagnosis and 21% did not have positive initial chest imaging. Uncertainty in documentation was common (58% in ED notes and 48% in discharge notes). Greater uncertainty was seen for patients with discordant diagnoses, who also received additional treatments; compared with concordant patients, only those lacking an initial pneumonia diagnosis had higher 30-day mortality (14.4% vs 10.6%).