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  1. Wei Shen Lim1,
  2. Mark Woodhead2
  1. 1Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK
  2. 2Department of Respiratory Medicine, Manchester Royal Infirmary, Manchester, UK
  1. Correspondence to Dr Wei Shen Lim, Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, City Hospital Campus, Nottingham NG5 1PB, UK; weishen.lim{at}

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We read with interest the comments of Dr Singh and colleagues.1 We note that in the data submitted from their local population they found a lower mortality for patients with high severity community acquired pneumonia (CAP) (CURB65 score 3–5) than was found in the National cohort.2 It is not possible to precisely explain this difference from the available information, but there are a number of likely explanations. The first is sampling error, which will be inevitable when small numbers of cases are submitted from a large number although their local data collected over a longer time period than the British Thoracic Society (BTS) audit suggest that their lower mortality score is real. A differential response to treatment is a consideration, but since only selected aspects of patient care were documented in the audit, this …

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  • Competing interests None.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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