Standardized Interpretation of Chest Radiographs in Cases of Pediatric Pneumonia From the PERCH Study
| Autor: | Breanna Barger-Kamate, Rasa Izadnegahdar, Christine Prosperi, Fergus V. Gleeson, Fariha Bushra Matin, Mahamadou Diallo, Bernard E. Ebruke, Laura L. Hammitt, Anchalee Kruatrachue, Musaku Mwenechanya, Piyarat Suntarattiwong, Wenfeng Gong, Katherine L. O'Brien, Claire Oluwalana, Nicholas Fancourt, Joyce Sande, Nasreen Mahomed, Veronica Manduku, David P. Moore, Shabir A. Madhi, Maria Deloria Knoll, Kamrun Nahar, Margaret de Campo, Micah Silaba Ominde, John de Campo, Daniel R. Feikin |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Microbiology (medical)
Male Pediatrics medicine.medical_specialty pediatrics Radiography 030231 tropical medicine Interpretation Process World Health Organization Child health World health 03 medical and health sciences 0302 clinical medicine medicine Humans 030212 general & internal medicine diagnosis chest radiograph medicine.diagnostic_test business.industry Infant Pneumonia Reference Standards medicine.disease observer variation 3. Good health Bacterial vaccine Hospitalization Infectious Diseases Child Preschool Etiology Female Radiography Thoracic Supplement Article business Chest radiograph |
| Zdroj: | Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America |
| ISSN: | 1058-4838 |
| Popis: | Background. Chest radiographs (CXRs) are a valuable diagnostic tool in epidemiologic studies of pneumonia. The World Health Organization (WHO) methodology for the interpretation of pediatric CXRs has not been evaluated beyond its intended application as an endpoint measure for bacterial vaccine trials. Methods. The Pneumonia Etiology Research for Child Health (PERCH) study enrolled children aged 1–59 months hospitalized with WHO-defined severe and very severe pneumonia from 7 low- and middle-income countries. An interpretation process categorized each CXR into 1 of 5 conclusions: consolidation, other infiltrate, both consolidation and other infiltrate, normal, or uninterpretable. Two members of a 14-person reading panel, who had undertaken training and standardization in CXR interpretation, interpreted each CXR. Two members of an arbitration panel provided additional independent reviews of CXRs with discordant interpretations at the primary reading, blinded to previous reports. Further discordance was resolved with consensus discussion. Results. A total of 4172 CXRs were obtained from 4232 cases. Observed agreement for detecting consolidation (with or without other infiltrate) between primary readers was 78% (κ = 0.50) and between arbitrators was 84% (κ = 0.61); agreement for primary readers and arbitrators across 5 conclusion categories was 43.5% (κ = 0.25) and 48.5% (κ = 0.32), respectively. Disagreement was most frequent between conclusions of other infiltrate and normal for both the reading panel and the arbitration panel (32% and 30% of discordant CXRs, respectively). Conclusions. Agreement was similar to that of previous evaluations using the WHO methodology for detecting consolidation, but poor for other infiltrates despite attempts at a rigorous standardization process. |
| Databáze: | OpenAIRE |
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