Author’s reply
We agree with Challen and colleagues that mortality prediction tools and early warning scores should only be used to predict what they have been validated to predict. It is important to recognise, however, that early warning scores have been widely implemented in acute medicine in the UK, and it is therefore inevitable that junior and inexperienced physicians will use these as prognostic tools and to guide the intensity of intervention required in community acquired pneumonia (CAP). The need for higher level care, albeit important, is not the only clinical decision that needs to be taken when a patient with CAP is admitted to hospital. For example, the physician also needs to decide about the intensity of antibiotic therapy and other supportive measures, and prognostic assessment may also be …
