[The chest x-ray in acute bronchiolitis: Technical quality, findings, and an assessment of its reliability].

Autor:	Rius Peris JM; Hospital Virgen de la Luz, Cuenca, España; Instituto de Tecnología, Universidad de Castilla-La Mancha, Cuenca, España. Electronic address: riusjua@gmail.com., Maraña Pérez AI; Hospital Virgen de la Luz, Cuenca, España; Instituto de Tecnología, Universidad de Castilla-La Mancha, Cuenca, España., Valiente Armero A; Hospital Virgen de la Luz, Cuenca, España., Mateo Sotos J; Hospital Virgen de la Luz, Cuenca, España; Instituto de Tecnología, Universidad de Castilla-La Mancha, Cuenca, España., Guardia Nieto L; Hospital Virgen de la Luz, Cuenca, España., Torres AM; Hospital Virgen de la Luz, Cuenca, España; Instituto de Tecnología, Universidad de Castilla-La Mancha, Cuenca, España., Cueto Calvo EM; Hospital Virgen de la Luz, Cuenca, España.
Jazyk:	Spanish; Castilian
Zdroj:	Anales de pediatria [An Pediatr (Engl Ed)] 2021 Mar; Vol. 94 (3), pp. 129-135. Date of Electronic Publication: 2020 May 25.
DOI:	10.1016/j.anpedi.2020.03.011
Abstrakt:	Introduction: Despite the recommendations of the current Clinical Practice Guidelines, the chest x-ray continues to be a widely used diagnostic test in the assessment of infants with acute bronchiolitis (AB). However, there have not been many studies that have assessed its reproducibility in these patients. In the present study, an evaluation is made on the radiographs, describing their quality, their radiological findings, and provides new evidence on the agreement between observers. Method: Out of a total of 281 infants admitted due to acute bronchiolitis, 140 chest x-rays were performed. Twelve doctors from different specialities evaluated the presence or absence of 10 radiological signs previously agreed by consensus. The level of agreement between 2 observers, and in groups of 3 or more, were analysed using the Cohen and Fleiss kappa index, respectively. Results: Only 8.5% of the radiographs showed evidence of a complicated AB. The between-observer agreement in groups of 3 or more was medium, and with little variability (kappa: 0.20-0.40). However, between 2 observers, each observer against radiologist, the variability was wider, (kappa: -0.20-0.60). This level of agreement was associated with factors including, the sign to evaluate, the medical specialty, and level of professional experience. Conclusion: The low levels of agreement between observers and the wide variability, makes the chest x-ray an unreliable diagnostic tool, and is not recommended for the assessment of infants with AB. (Copyright © 2020. Publicado por Elsevier España, S.L.U.)
Databáze:	MEDLINE
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