The accuracy of teleradiologists in diagnosing COVID-19 based on a French multicentric emergency cohort
Autor: | Nicolas Favard, François Petitpierre, Basile Porta, Grégoire Bouquet, Alexandre Ben Cheikh, Emile Youssof, Florian Alonzo-Lacroix, Julien Balique, Thomas Ayoub, Nathan Banaste, Hubert Nivet, Vivien Thomson, Jean-François Bergerot, Guillaume Gorincour, Flavie Bratan, Amandine Crombé, Paul Schuster, Charles Mastier, Laurent Pourriol, Alban Chazot |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Adult
medicine.medical_specialty Teleradiology Prevalence Sensitivity and Specificity 030218 nuclear medicine & medical imaging Hospital 03 medical and health sciences 0302 clinical medicine Cohen's kappa medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Medical diagnosis Prospective cohort study Neuroradiology medicine.diagnostic_test SARS-CoV-2 business.industry Tomography X-ray computed COVID-19 Interventional radiology General Medicine Polymerase chain reaction Radiology Nuclear Medicine and imaging 030220 oncology & carcinogenesis Cohort Chest Radiology Coronavirus Infections Emergency Service Hospital business Emergency service Kappa |
Zdroj: | European Radiology |
ISSN: | 1432-1084 0938-7994 |
DOI: | 10.1007/s00330-020-07345-z |
Popis: | Objectives To evaluate the accuracy of diagnoses of COVID-19 based on chest CT as well as inter-observer agreement between teleradiologists during on-call duty and senior radiologists in suspected COVID-19 patients. Materials and methods From March 13, 2020, to April 14, 2020, consecutive suspected COVID-19 adult patients who underwent both an RT-PCR test and chest CT from 15 hospitals were included in this prospective study. Chest CTs were immediately interpreted by the on-call teleradiologist and were systematically blind reviewed by a senior radiologist. Readings were categorised using a five-point scale: (1) normal; (2) non-infectious findings; (3) infectious findings but not consistent with COVID-19 infection; (4) consistent with COVID-19 infection; and (5) typical appearance of COVID-19 infection. The diagnostic accuracy of chest CT and inter-observer agreement using the kappa coefficient were evaluated over the study period. Results In total, 513 patients were enrolled, of whom 244/513 (47.6%) tested positive for RT-PCR. First readings were scored 4 or 5 in 225/244 (92%) RT-PCR+ patients, and between 1 and 3 in 201/269 (74.7%) RT-PCR− patients. The data were highly consistent (weighted kappa = 0.87) and correlated with RT-PCR (p < 0.001, AUC1st-reading = 0.89, AUC2nd-reading = 0.93). The negative predictive value for scores of 4 or 5 was 0.91–0.92, and the PPV for a score of 5 was 0.89–0.96 at the first and second readings, respectively. Diagnostic accuracy was consistent over the study period, irrespective of a variable prevalence rate. Conclusion Chest CT demonstrated high diagnostic accuracy with strong inter-observer agreement between on-call teleradiologists with varying degrees of experience and senior radiologists over the study period. Key Points • The accuracy of readings by on-call teleradiologists, relative to second readings by senior radiologists, demonstrated a sensitivity of 0.75–0.79, specificity of 0.92–0.97, NPV of 0.80–0.83, and PPV of 0.89–0.96, based on “typical appearance,” as predictive of RT-PCR+. • Inter-observer agreement between the first reading in the emergency setting and the second reading by the senior emergency teleradiologist was excellent (weighted kappa = 0.87). Electronic supplementary material The online version of this article (10.1007/s00330-020-07345-z) contains supplementary material, which is available to authorized users. |
Databáze: | OpenAIRE |
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