Reading and interpretation of chest X-ray in adults with community-acquired pneumonia
Braz. j. infect. dis
;
15(6): 540-546, Nov.-Dec. 2011. tab
Article
in English
| LILACS
| ID: lil-610524
ABSTRACT
INTRODUCTION:
Traditional reading of chest X-rays usually has a low prognostic value and poor agreement.OBJECTIVE:
This study aimed to determine the interobserver and intraobserver agreement using two reading formats in patients with community-acquired pneumonia, and to explore their association with etiology and clinical outcomes.METHODS:
A pulmonologist and a radiologist, who were blind to clinical data, interpreted 211 radiographs using a traditional analysis format (type and location of pulmonary infiltrates and pleural findings), and a quantitative analysis (pulmonary damage categorized from 0 to 10). For both, the interobserver and intraobserver agreement was estimated (Kappa statistic and intraclass correlation coefficient). The latter was assessed in a subsample of 25 radiographs three months after the initial reading. Finally, the observers made a joint reading to explore its prognostic usefulness via multivariate analysis.RESULTS:
Seventy-four chest radiographs were discarded due to poor quality. With the traditional reading, the mean interobserver agreement was moderate (0.43). It was considered good when the presence of pleural effusion, and the location of the infiltrates in the right upper lobe and both lower lobes, were evaluated; moderate for multilobar pneumonia; and poor for the type of infiltrates. The mean intraobserver agreement for each reviewer was 0.71 and 0.5 respectively. The quantitative reading had an agreement between good and excellent (interobserver 0.72, intraobserver 0.85 and 0.61). Radiological findings were neither associated to a specific pathogen nor to mortality.CONCLUSION:
In patients with pneumonia, the interpretation of the chest X-ray, especially the smallest of details, depends solely on the reader.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Pneumonia
Type of study:
Etiology study
/
Incidence study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
Language:
English
Journal:
Braz. j. infect. dis
Journal subject:
Communicable Diseases
Year:
2011
Type:
Article
/
Project document
Affiliation country:
Colombia
Institution/Affiliation country:
Universidad de Antioquia/CO
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