Evaluation of the World Health Organization criteria for chest radiographs for pneumonia diagnosis in children.
Unlabelled: Our objective was to compare the inter-observer level of agreement in diagnosing pneumonia using the World Health Organization (WHO) guidelines for the interpretation of radiographs. We conducted a prospective study in a pediatric emergency room. Fifteen observers (13 pediatricians, 2 ra...
| Publicado en: | European Journal of Pediatrics Vol. 171; no. 2; pp. 369 - 375 |
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| Autores principales: | , , , , , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Springer Nature
Feb2012
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104399191&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104399191 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03406199 CR1 jtl: European Journal of Pediatrics issn: 03406199 maglogo: N pubinfo: dt: Feb2012 vid: 171 iid: 2 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 104399191 NLM21870077 2011769383 10.1007/s00431-011-1543-1 NLM21870077 104399191 ppf: 369 ppct: 6 formats: fmt: @attributes: type: P tig: atl: Evaluation of the World Health Organization criteria for chest radiographs for pneumonia diagnosis in children. aug: au: Ben Shimol S Dagan R Givon-Lavi N Tal A Aviram M Bar-Ziv J Zodicov V Greenberg D Ben Shimol, Shalom Dagan, Ron Givon-Lavi, Noga Tal, Asher Aviram, Micha Bar-Ziv, Jacob Zodicov, Vadim Greenberg, David affil: Pediatric Infectious Disease Unit, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel sug: subj: Pneumonia Radiography Practice Guidelines Child, Preschool Diagnostic Errors Human Infant Infant, Newborn Observer Bias Prospective Studies Single-Blind Studies World Health Organization Child, Preschool: 2-5 years Infant: 1-23 months Infant, Newborn: birth-1 month ab: Unlabelled: Our objective was to compare the inter-observer level of agreement in diagnosing pneumonia using the World Health Organization (WHO) guidelines for the interpretation of radiographs. We conducted a prospective study in a pediatric emergency room. Fifteen observers (13 pediatricians, 2 radiologists) interpreted 200 pediatric (<5 years old) chest radiographs using the WHO guidelines. Observers were blinded to the clinical presentation. RESULTS were analyzed for kappa values. Individual readings were compared to two "gold standard" teams: (1) radiologist and pediatrician and (2) two radiologists.Results: Alveolar pneumonia, non-alveolar pneumonia, and no pneumonia were found (by radiologists) in 12.8%, 2.7%, and 78.6% of readings, respectively. The mean kappa values for alveolar pneumonia, non-alveolar pneumonia, and no pneumonia of observers versus the team consisting of a radiologist and a pediatrician were 0.73, 0.23, and 0.61, respectively. For non-alveolar pneumonia, the mean kappa value was higher for the gold standard consisting of a radiologist and a pediatrician when compared to the two-radiologist team. Pediatricians overdiagnosed "non-alveolar pneumonia" compared with radiologists. In contrast, for the alveolar pneumonia and no-pneumonia diagnoses, no significant differences were found.Conclusions: The WHO guidelines for interpretation of chest radiographs result in high level of agreement between readers for the definition of "alveolar pneumonia" and "no pneumonia" but poor agreement for non-alveolar pneumonia. The disagreement with regard to the latter was associated with overdiagnosis by pediatricians, which may lead to overtreatment. We believe that radiographic non-alveolar pneumonia should not be an endpoint for clinical trials and research, nor should it be implemented in clinical setting. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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