Interpretation of pediatric chest radiographs by non-radiologist clinicians in Botswana using World Health Organization criteria for endpoint pneumonia.

Autor:	Fawole OA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.; Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, PA, USA.; New York University School of Medicine, New York, NY, USA., Kelly MS; Botswana-UPenn Partnership, University of Botswana Main Campus, P.O. Box AC 157 ACH, Gaborone, Botswana.; Global Health Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA.; Division of Pediatric Infectious Diseases, Duke University Medical Center, Durham, NC, USA., Steenhoff AP; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.; Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, PA, USA.; Botswana-UPenn Partnership, University of Botswana Main Campus, P.O. Box AC 157 ACH, Gaborone, Botswana.; Global Health Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA.; Department of Pediatrics and Adolescent Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana.; Department of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA., Feemster KA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.; Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, PA, USA.; Global Health Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA.; Department of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.; Division of Disease Control, Philadelphia Department of Public Health, Philadelphia, PA, USA., Crotty EJ; Department of Radiology and Medical Imaging, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA., Rattan MS; Department of Radiology and Medical Imaging, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA., David T; Department of Pediatrics and Adolescent Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana., Mazhani T; Department of Pediatrics and Adolescent Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana., Shah SS; Divisions of Hospital Medicine and Infectious Diseases, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA., Andronikou S; Department of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.; Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.; Department of Radiology, University of Cape Town, Cape Town, South Africa., Arscott-Mills T; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. tonyaarscottmillsbup@gmail.com.; Botswana-UPenn Partnership, University of Botswana Main Campus, P.O. Box AC 157 ACH, Gaborone, Botswana. tonyaarscottmillsbup@gmail.com.; Global Health Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA. tonyaarscottmillsbup@gmail.com.; Department of Pediatrics and Adolescent Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana. tonyaarscottmillsbup@gmail.com.; Department of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA. tonyaarscottmillsbup@gmail.com.
Jazyk:	angličtina
Zdroj:	Pediatric radiology [Pediatr Radiol] 2020 Jun; Vol. 50 (7), pp. 913-922. Date of Electronic Publication: 2020 Jun 10.
DOI:	10.1007/s00247-020-04625-0
Abstrakt:	Background: In low- and middle-income countries, chest radiographs are most frequently interpreted by non-radiologist clinicians. Objective: We examined the reliability of chest radiograph interpretations performed by non-radiologist clinicians in Botswana and conducted an educational intervention aimed at improving chest radiograph interpretation accuracy among non-radiologist clinicians. Materials and Methods: We recruited non-radiologist clinicians at a referral hospital in Gaborone, Botswana, to interpret de-identified chest radiographs for children with clinical pneumonia. We compared their interpretations with those of two board-certified pediatric radiologists in the United States. We evaluated associations between level of medical training and the accuracy of chest radiograph findings between groups, using logistic regression and kappa statistics. We then developed an in-person training intervention led by a pediatric radiologist. We asked participants to interpret 20 radiographs before and immediately after the intervention, and we compared their responses to those of the facilitating radiologist. For both objectives, our primary outcome was the identification of primary endpoint pneumonia, defined by the World Health Organization as presence of endpoint consolidation or endpoint effusion. Results: Twenty-two clinicians interpreted chest radiographs in the primary objective; there were no significant associations between level of training and correct identification of endpoint pneumonia; concordance between respondents and radiologists was moderate (κ=0.43). After the training intervention, participants improved agreement with the facilitating radiologist for endpoint pneumonia from fair to moderate (κ=0.34 to κ=0.49). Conclusion: Non-radiologist clinicians in Botswana do not consistently identify key chest radiographic findings of pneumonia. A targeted training intervention might improve non-radiologist clinicians' ability to interpret chest radiographs.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu Full text from SpringerLink