Standardized interpretation of paediatric chest radiographs for the diagnosis of pneumonia in epidemiological studies.
BACKGROUND: Although radiological pneumonia is used as an outcome measure in epidemiological studies, there is considerable variability in the interpretation of chest radiographs. A standardized method for identifying radiological pneumonia would facilitate comparison of the results of vaccine trial...
| Publicado en: | Bulletin of the World Health Organization Vol. 83; no. 5; pp. 353 - 360 |
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| Autores principales: | , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
World Health Organization
May2005
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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=106497160&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106497160 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00429686 BUW jtl: Bulletin of the World Health Organization issn: 00429686 maglogo: N pubinfo: dt: May2005 vid: 83 iid: 5 pid: 437 pub: World Health Organization artinfo: ui: 106497160 106497160 2005118820 NLM15976876 106497160 ppf: 353 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Standardized interpretation of paediatric chest radiographs for the diagnosis of pneumonia in epidemiological studies. aug: au: Cherian T Mulholland EK Carlin JB Ostensen H Amin R de Campo M Greenberg D Lagos R Lucero M Madhi SA O'Brien KL Obaro S Steinhoff MC affil: Initiative for Vaccine Research, Department of Immunization, Vaccines and Biologicals, World Health Organization, 1211 Geneva 27, Switzerland; cheriant@who.int sug: subj: Pneumonia Radiography X-Rays Evaluation Child Data Analysis Software Data Analysis, Statistical Descriptive Statistics Interrater Reliability Intrarater Reliability kappa Statistic Observational Methods Sensitivity and Specificity Human Child: 6-12 years ab: BACKGROUND: Although radiological pneumonia is used as an outcome measure in epidemiological studies, there is considerable variability in the interpretation of chest radiographs. A standardized method for identifying radiological pneumonia would facilitate comparison of the results of vaccine trials and epidemiological studies of pneumonia. METHODS: A WHO working group developed definitions for radiological pneumonia. Inter-observer variability in categorizing a set of 222 chest radiographic images was measured by comparing the readings made by 20 radiologists and clinicians with a reference reading. Intra-observer variability was measured by comparing the initial readings of a randomly chosen subset of 100 radiographs with repeat readings made 8-30 days later. FINDINGS: Of the 222 images, 208 were considered interpretable. The reference reading categorized 43% of these images as showing alveolar consolidation or pleural effusion (primary end-point pneumonia); the proportion thus categorized by each of the 20 readers ranged from 8% to 61%. Using the reference reading as the gold standard, 14 of the 20 readers had sensitivity and specificity of > 0.70 in identifying primary end-point pneumonia; 13 out of 20 readers had a kappa index of > 0.6 compared with the reference reading. For the 92 radiographs deemed to be interpretable among the 100 images used for intra-observer variability, 19 out of 20 readers had a kappa index of > 0.6. CONCLUSION: Using standardized definitions and training, it is possible to achieve agreement in identifying radiological pneumonia, thus facilitating the comparison of results of epidemiological studies that use radiological pneumonia as an outcome. Copyright © 2005 World Health Organization pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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