Interobserver agreement in interpretation of chest radiographs for pediatric community acquired pneumonia: Findings of the pedCAPNETZ-cohort

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Gesche M. Voigt - , Universitätsklinikum Schleswig-Holstein Campus Lübeck, Airway Research Center North (ARCN) - DZL-Standort Borstel (Autor:in)
  • Dominik Thiele - , Airway Research Center North (ARCN) - DZL-Standort Borstel, Universitätsklinikum Schleswig-Holstein Campus Lübeck (Autor:in)
  • Martin Wetzke - , Airway Research Center North (ARCN) - DZL-Standort Borstel, Medizinische Hochschule Hannover (MHH) (Autor:in)
  • Jürgen Weidemann - , Children's and Youth Hospital auf der Bult (Autor:in)
  • Patricia Maria Parpatt - , Klinikum Oldenburg (Autor:in)
  • Tobias Welte - , Airway Research Center North (ARCN) - DZL-Standort Borstel, Medizinische Hochschule Hannover (MHH) (Autor:in)
  • Jürgen Seidenberg - , University of Oldenburg (Autor:in)
  • Christian Vogelberg - , Hochschulmedizin (Medizinische Fakultät und Universitätsklinikum), Klinik und Poliklinik für Kinder- und Jugendmedizin (Autor:in)
  • Holger Koster - , University of Oldenburg (Autor:in)
  • Gernot G.U. Rohde - , Airway Research Center North (ARCN) - DZL-Standort Borstel, Universitätsklinikum Frankfurt (Autor:in)
  • Christoph Härtel - , Universitätsklinikum Schleswig-Holstein Campus Lübeck, Julius-Maximilians-Universität Würzburg (Autor:in)
  • Gesine Hansen - , Airway Research Center North (ARCN) - DZL-Standort Borstel, Medizinische Hochschule Hannover (MHH) (Autor:in)
  • Matthias V. Kopp - , Universitätsklinikum Schleswig-Holstein Campus Lübeck, Airway Research Center North (ARCN) - DZL-Standort Borstel, Universität Bern (Autor:in)

Abstract

Although chest radiograph (CXR) is commonly used in diagnosing pediatric community acquired pneumonia (pCAP), limited data on interobserver agreement among radiologists exist. PedCAPNETZ is a prospective, observational, and multicenter study on pCAP. N = 233 CXR from patients with clinical diagnosis of pCAP were retrieved and n = 12 CXR without pathological findings were added. All CXR were interpreted by a radiologist at the site of recruitment and by two external, blinded pediatric radiologists. To evaluate interobserver agreement, the reporting of presence or absence of pCAP in CXR was analyzed, and prevalence and bias-adjusted kappa (PABAK) statistical testing was applied. Overall, n = 190 (82%) of CXR were confirmed as pCAP by two external pediatric radiologists. Compared with patients with pCAP negative CXR, patients with CXR-confirmed pCAP displayed higher C-reactive protein levels and a longer duration of symptoms before enrollment (p <.007). Further parameters, that is, age, respiratory rate, and oxygen saturation showed no significant difference. The interobserver agreement between the onsite radiologists and each of the two independent pediatric radiologists for the presence of pCAP was poor to fair (69%; PABAK = 0.39% and 76%; PABAK = 0.53, respectively). The concordance between the external radiologists was fair (81%; PABAK = 0.62). With regard to typical CXR findings for pCAP, chance corrected interrater agreement was highest for pleural effusions, infiltrates, and consolidations and lowest for interstitial patterns and peribronchial thickening. Our data show a poor interobserver agreement in the CXR-based diagnosis of pCAP and emphasized the need for harmonized interpretation standards.

Details

OriginalspracheEnglisch
Seiten (von - bis)2676-2685
Seitenumfang10
FachzeitschriftPediatric pulmonology
Jahrgang56
Ausgabenummer8
PublikationsstatusVeröffentlicht - Aug. 2021
Peer-Review-StatusJa

Externe IDs

PubMed 34076967

Schlagworte

Schlagwörter

  • antibiotic therapy, imaging, infections: pneumonia, TB, viral