Our study: Differences between patients in whom physicians agree and disagree about the diagnosis of ARDS, with Tim Hofer, Ivan Co, @Jakob_McSparron, @iwashyna now at @AnnalsATS @davidlederer #VisualAbstract atsjournals.org/doi/abs/10.151… 1/7 
738 patients with AHRF (PF<300 on vent) were independently, retrospectively reviewed by multiple critical care MDs for ARDS. 110 had consensus among MDs that ARDS developed, 100 had disagreement 2/7
Average days of severe hypoxia (PF<100) longer in pts with consensus-ARDS (3.2 days) than pts with disagreement (2.0 days), but mortality similar (37% vs 35%) 3/7
ARDS risk factors matter: pts with pna + shock + P/F<120 nearly always had consensus ARDS, patients without risk factors and P/F>180 never had ARDS 4/7
Rates of ARDS diagnosis among physicians reviewing the same pts varied considerably, from 9-47%! 5/7
Physicians always agree that pts with typical risk factors, most severe lung injury have ARDS, but disagree on pts along the middle of the spectrum. 6/7
When ARDS diagnosis matters (for invasive treatments or research settings), consider getting multiple opinions 7/7
