Diagnostic performance of the RSNA-proposed classification for COVID-19 pneumonia versus pre-pandemic controls
Braz. j. infect. dis
;
26(1): 101665, 2022. tab, graf
Article
in English
|
LILACS-Express
| LILACS
| ID: biblio-1364545
ABSTRACT
Abstract Objective To evaluate the diagnostic accuracy of the Radiological Society of North America (RSNA) classification system for coronavirus disease 2019 (COVID-19) pneumonia compared to pre-pandemic chest computed tomography (CT) scan images to mitigate the risk of bias regarding the reference standard. Materials and methods This was a retrospective, cross-sectional, diagnostic test accuracy study. Chest CT scans, carried out from May 1 to June 30, 2020, and from May 1 to July 17, 2017, were consecutively selected for the COVID-19 (positive reverse transcription-polymerase chain reaction [RT-PCR] for severe acute respiratory syndrome coronavirus 2 result) and control (pre-pandemic) groups, respectively. Four expert thoracic radiologists blindly interpreted each CT scan image. Sensitivity and specificity were calculated. Results A total of 160 chest CT scan images were included 79 in the COVID-19 group (56 [43.5-67] years old, 41 men) and 81 in the control group (62 [52-72] years old, 44 men). Typically, an estimated specificity of 98.5% (95% confidence interval [CI] 98.1%-98.4%) was obtained. For the indeterminate classification as a diagnostic threshold, an estimated sensitivity of 88.3% (95% CI 84.7%-91.7%) and a specificity of 79.0% (95% CI 74.5%-83.4%), with an area under the curve of 0.865 (95% CI 0.838-0.895), were obtained. Conclusion The RSNA classification system shows strong diagnostic accuracy for COVID-19 pneumonia, even against pre-pandemic controls. It can be an important aid in clinical decision-making, especially when a typical or indeterminate pattern is found, possibly advising retesting following an initial negative RT-PCR result and streamlining early management and isolation.
Full text:
Available
Index:
LILACS (Americas)
Type of study:
Diagnostic study
/
Prognostic study
Language:
English
Journal:
Braz. j. infect. dis
Journal subject:
Communicable Diseases
Year:
2022
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Hospital de Clínicas de Porto Alegre (HCPA)/BR
/
Hospital de Clínicas de Porto Alegre/BR
/
Universidade Federal do Rio Grande do Sul/BR
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