Comparison of chest X-ray interpretation by Emergency Department clinicians and radiologists in suspected COVID-19 infection: a retrospective cohort study.

Autor:	Kemp OJ; Southmead Hospital Emergency Department, North Bristol NHS Trust, Bristol, United Kingdom., Watson DJ; Southmead Hospital Emergency Department, North Bristol NHS Trust, Bristol, United Kingdom., Swanson-Low CL; Southmead Hospital Emergency Department, North Bristol NHS Trust, Bristol, United Kingdom.; Emergency Care Research Group, Faculty of Health and Applied Sciences, University of the West of England Bristol, Bristol, United Kingdom., Cameron JA; Southmead Hospital Emergency Department, North Bristol NHS Trust, Bristol, United Kingdom., Von Vopelius-Feldt J
Jazyk:	angličtina
Zdroj:	BJR open [BJR Open] 2020 Aug 28; Vol. 2 (1), pp. 20200020. Date of Electronic Publication: 2020 Aug 28 (Print Publication: 2020).
DOI:	10.1259/bjro.20200020
Abstrakt:	Objectives: We describe the inter-rater agreement between Emergency Department (ED) clinicians and reporting radiologists in the interpretation of chest X-rays (CXRs) in patients presenting to ED with suspected COVID-19. Methods: We undertook a retrospective cohort study of patients with suspected COVID-19. We compared ED clinicians' and radiologists' interpretation of the CXRs according to British Society of Thoracic Imaging (BSTI) guidelines, using the area under the receiver operator curve (ROC area). Results: CXRs of 152 cases with suspected COVID-19 infection were included. Sensitivity and specificity for 'classic' COVID-19 CXR findings reported by ED clinician was 84 and 83%, respectively, with a ROC area of 0.84 (95%CI 0.77 to 0.90). Accuracy improved with ED clinicians' experience, with ROC areas of 0.73 (95%CI 0.45 to 1.00), 0.81 (95%CI 0.73 to 0.89), 1.00 (95%CI 1.00 to 1.00) and 0.90 (95%CI 0.70 to 1.00) for foundation year doctors, senior house officers, higher speciality trainees and ED consultants, respectively ( p < 0.001). Conclusions: ED clinicians demonstrated moderate inter-rater agreement with reporting radiologists according to the BSTI COVID-19 classifications. The improvement in accuracy with ED clinician experience suggests training of junior ED clinicians in the interpretation of COVID-19 related CXRs might be beneficial. Large-scale survey studies might be useful in the further evaluation of this topic. Advances in Knowledge: This is the first study to examine inter-rater agreement between ED clinicians and radiologists in regards to COVID-19 CXR interpretation.Further service configurations such as 24-hr hot reporting of CXRs can be guided by these data, as well as an ongoing, nationwide follow-up study. Competing Interests: Competing interests: The authors have no conflict of interest or source of funding to declare. (© 2020 The Authors. Published by the British Institute of Radiology.)
Databáze:	MEDLINE
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