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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In the past, epidemiologists derived conclusions from large data sets, whereas clinicians analyzed smaller series of individually characterized cases. Increasingly, clinicians attempt to derive conclusions from large sets of variably defined data; the conclusions may be erroneous.

A case in point is the recent report of 1669 patients hospitalized for "community-acquired pneumonia."¹ The authors found that gram stain and culture of sputum were useful in only 14% of patients. The accompanying editorial regarded these microbiologic techniques as a sacred cow that should be sent out to pasture.²

In contrast, in a recent study of 105 patients with pneumococcal pneumonia proven by blood culture,³ my colleagues and I showed that a sputum sample obtained before antibiotics were administered or in the first few hours thereafter had a greater than 80% likelihood of sensitivity by gram stain or culture of revealing Streptococcus pneumoniae. This study used data obtained by routine microbiologic . . . [Full Text of this Article]

AUTHOR INFORMATION
Daniel M. Musher, MD

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