Uncertainty analysis of chest X-ray lung height measurements and size matching for lung transplantation.

Autor:	Vazquez Guillamet R; Division of Pulmonary and Critical Care Medicine at Washington University - Barnes Jewish Hospital, St. Louis, MO, USA., Vazquez Guillamet MC; Division of Pulmonary and Critical Care Medicine at Washington University - Barnes Jewish Hospital, St. Louis, MO, USA.; Division of Infectious Diseases at Washington University - Barnes Jewish Hospital, St. Louis, MO, USA., Rjob A; Division of Infectious Diseases at Washington University - Barnes Jewish Hospital, St. Louis, MO, USA., Bierhals A; Radiology Department at Washington University - Barnes Jewish Hospital, St. Louis, MO, USA., Bello I; Division of Thoracic Surgery and Lung Transplantation at Vall d'Hebron University Hospital, Barcelona, Spain., Abularach AJ; Division of Thoracic Surgery and Lung Transplantation at Vall d'Hebron University Hospital, Barcelona, Spain., Tague L; Division of Pulmonary and Critical Care Medicine at Washington University - Barnes Jewish Hospital, St. Louis, MO, USA., Wallendorf M; Division of Statistics at Washington University School of Medicine, St. Louis, MO, USA., Marklin GF; Mid-America Transplant, St. Louis, MO, USA., Witt C; Division of Pulmonary and Critical Care Medicine at Washington University - Barnes Jewish Hospital, St. Louis, MO, USA., Byers DE; Division of Pulmonary and Critical Care Medicine at Washington University - Barnes Jewish Hospital, St. Louis, MO, USA., Kreisel D; Division of Thoracic Surgery at Washington University - Barnes Jewish Hospital, St. Louis, MO, USA., Nava R; Division of Thoracic Surgery at Washington University - Barnes Jewish Hospital, St. Louis, MO, USA., Puri V; Division of Thoracic Surgery at Washington University - Barnes Jewish Hospital, St. Louis, MO, USA., Hachem R; Division of Pulmonary and Critical Care Medicine at Washington University - Barnes Jewish Hospital, St. Louis, MO, USA., Trulock EP; Division of Pulmonary and Critical Care Medicine at Washington University - Barnes Jewish Hospital, St. Louis, MO, USA.
Jazyk:	angličtina
Zdroj:	Journal of thoracic disease [J Thorac Dis] 2022 Apr; Vol. 14 (4), pp. 1042-1051.
DOI:	10.21037/jtd-21-1755
Abstrakt:	Background: Errors in measuring chest X-ray (CXR) lung heights could contribute to the occurrence of size-mismatched lung transplant procedures. Methods: We first used Bland-Altman analysis for repeated measures to evaluate contributors to measurement error of chest X-ray lung height. We then applied error propagation theory to assess the impact of measurement error on size matching for lung transplantation. Results: A total 387 chest X-rays from twenty-five donors and twenty-five recipients were measured by two raters. Individual standard deviation for lung height differences were independent of age, sex, donor vs. recipient, diagnostic group and race/ethnicity and all were pooled for analysis. Bias between raters was 0.27 cm (±0.03) and 0.22 cm (±0.06) for the right and left lung respectively. Within subject variability was the biggest contributor to error in measurement, 2.76 cm (±0.06) and 2.78 cm (±0.2) for the right and left lung height. A height difference of 4.4 cm or more (95% CI: ±4.2, ±4.6 cm) between the donor and the recipient right lung height has to be accepted to ensure matching for at least 95% of patients with the same true lung height. This difference decreases to ±1.1 cm (95% CI: ±0.9, ±1.3 cm) when the average from all available chest X-rays is used. The probability of matching a donor and a recipient decreases with increasing true lung height difference. Conclusions: Individual chest X-ray lung heights are imprecise for the purpose of size matching in lung transplantation. Averaging chest X-rays lung heights reduced uncertainty. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-21-1755/coif). DK serves as an unpaid editorial board member of Journal of Thoracic Disease. RVG reports that this research was supported by the Washington University Institute of Clinical and Translational Sciences Grant UL1TR002345 from the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH). The content is solely the responsibility of the authors and does not necessarily represent the official view of the NIH. MW reports receiving salary support from Grant UL1TR002345 from the National Center for Advancing Translational Science NCATS of the National Institute of Health (NIH). GFM is the Medical Director at Mid America Transplant. DEB reports receiving research funding from Mid-America Transplant. RH reports receiving research funding from Bristol Myers Squibb and Mallinkrodt, gent funding from Mid America Transplant and personal fees from Transmedics, CareDx, Thevavance, and Vectura. The other authors have no conflicts of interest to declare. (2022 Journal of Thoracic Disease. All rights reserved.)
Databáze:	MEDLINE
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