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Assessment of the comparative agreement between chest radiographs and CT scans in intensive care units.
Brooks, Daniel; Wright, Stephen E; Beattie, Anna; McAllister, Nadia; Anderson, Niall H; Roy, Alistair I; Gonsalves, Philip; Yates, Bryan; Graziadio, Sara; Mackie, Alasdair; Davidson, John; Gopal, Sandeep Vijaya; Whittle, Robert; Zahed, Asef; Barton, Lorna; Elameer, Mathew; Tuckett, John; Holmes, Rob; Sutcliffe, Alexandra; Santamaria, Nuria; de Lalouviere, Luke la Hausse; Gupta, Sanjay; Subramaniam, Jeevan; Pearson, Janaki A; Brandwood, Matthew; Burnham, Richard; Rostron, Anthony J; Simpson, A John.
Afiliación
  • Brooks D; Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne NE2 4HH, UK; Emergency Department, John Hunter Hospital, New Lambton Heights, NSW 2305, Australia.
  • Wright SE; Intensive Care Unit, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, High Heaton, Newcastle Upon Tyne NE7 7DN, UK.
  • Beattie A; Department of Radiology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne NE7 7DN, UK.
  • McAllister N; Intensive Care Unit, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, High Heaton, Newcastle Upon Tyne NE7 7DN, UK.
  • Anderson NH; Usher Institute, University of Edinburgh, Old Medial School, Teviot Place, Edinburgh EH8 9AG, UK.
  • Roy AI; Integrated Critical Care Unit, Sunderland Royal Hospital, Kayll Road, Sunderland SR4 7TP, UK.
  • Gonsalves P; Department of Radiology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne NE7 7DN, UK.
  • Yates B; Critical Care Unit, Northumbria Specialist Emergency Care Hospital, Northumbria Way, Cramlington NE23 6NZ, UK.
  • Graziadio S; NIHR Newcastle In Vitro Diagnostics Co-operative, Newcastle University, Newcastle upon Tyne NE2 4HH, UK; York Health Economics Consortium, University of York, York YO10 5NQ, UK.
  • Mackie A; Department of Radiology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne NE7 7DN, UK.
  • Davidson J; Intensive Care Unit, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, High Heaton, Newcastle Upon Tyne NE7 7DN, UK.
  • Gopal SV; Department of Radiology, Sunderland Royal Hospital, Kayll Road, Sunderland SR4 7TP, UK.
  • Whittle R; Critical Care Unit, Northumbria Specialist Emergency Care Hospital, Northumbria Way, Cramlington NE23 6NZ, UK.
  • Zahed A; Department of Radiology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne NE7 7DN, UK.
  • Barton L; Critical Care Unit, Northumbria Specialist Emergency Care Hospital, Northumbria Way, Cramlington NE23 6NZ, UK.
  • Elameer M; Department of Radiology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne NE7 7DN, UK.
  • Tuckett J; Department of Radiology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne NE7 7DN, UK.
  • Holmes R; Department of Radiology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne NE7 7DN, UK.
  • Sutcliffe A; Intensive Care Unit, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, High Heaton, Newcastle Upon Tyne NE7 7DN, UK.
  • Santamaria N; Department of Radiology, Sunderland Royal Hospital, Kayll Road, Sunderland SR4 7TP, UK; Department of Radiology, Clatterbridge Cancer Centre, l, Liverpool L7 8YA, UK.
  • de Lalouviere LH; Intensive Care Unit, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, High Heaton, Newcastle Upon Tyne NE7 7DN, UK.
  • Gupta S; Department of Radiology, Northumbria Specialist Emergency Care Hospital, Northumbria Way, Cramlington NE23 6NZ, UK.
  • Subramaniam J; Critical Care Unit, Northumbria Specialist Emergency Care Hospital, Northumbria Way, Cramlington NE23 6NZ, UK.
  • Pearson JA; Integrated Critical Care Unit, Sunderland Royal Hospital, Kayll Road, Sunderland SR4 7TP, UK; Intensive Care Unit, James Cook University Hospital, Middlesbrough TS4 3BW, UK.
  • Brandwood M; Integrated Critical Care Unit, Sunderland Royal Hospital, Kayll Road, Sunderland SR4 7TP, UK.
  • Burnham R; Critical Care Unit, Northumbria Specialist Emergency Care Hospital, Northumbria Way, Cramlington NE23 6NZ, UK.
  • Rostron AJ; Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne NE2 4HH, UK; Integrated Critical Care Unit, Sunderland Royal Hospital, Kayll Road, Sunderland SR4 7TP, UK.
  • Simpson AJ; Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne NE2 4HH, UK; NIHR Newcastle In Vitro Diagnostics Co-operative, Newcastle University, Newcastle upon Tyne NE2 4HH, UK; Respiratory Medicine, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne
J Crit Care ; 82: 154760, 2024 Aug.
Article en En | MEDLINE | ID: mdl-38492522
ABSTRACT

PURPOSE:

Chest radiographs in critically ill patients can be difficult to interpret due to technical and clinical factors. We sought to determine the agreement of chest radiographs and CT scans, and the inter-observer variation of chest radiograph interpretation, in intensive care units (ICUs).

METHODS:

Chest radiographs and corresponding thoracic computerised tomography (CT) scans (as reference standard) were collected from 45 ICU patients. All radiographs were analysed by 20 doctors (radiology consultants, radiology trainees, ICU consultants, ICU trainees) from 4 different centres, blinded to CT results. Specificity/sensitivity were determined for pleural effusion, lobar collapse and consolidation/atelectasis. Separately, Fleiss' kappa for multiple raters was used to determine inter-observer variation for chest radiographs.

RESULTS:

The median sensitivity and specificity of chest radiographs for detecting abnormalities seen on CTs scans were 43.2% and 85.9% respectively. Diagnostic sensitivity for pleural effusion was significantly higher among radiology consultants but no specialty/experience distinctions were observed for specificity. Median inter-observer kappa coefficient among assessors was 0.295 ("fair").

CONCLUSIONS:

Chest radiographs commonly miss important radiological features in critically ill patients. Inter-observer agreement in chest radiograph interpretation is only "fair". Consultant radiologists are least likely to miss thoracic radiological abnormalities. The consequences of misdiagnosis by chest radiographs remain to be determined.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Radiografía Torácica / Tomografía Computarizada por Rayos X / Variaciones Dependientes del Observador / Sensibilidad y Especificidad / Unidades de Cuidados Intensivos Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Crit Care Asunto de la revista: TERAPIA INTENSIVA Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Radiografía Torácica / Tomografía Computarizada por Rayos X / Variaciones Dependientes del Observador / Sensibilidad y Especificidad / Unidades de Cuidados Intensivos Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Crit Care Asunto de la revista: TERAPIA INTENSIVA Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Estados Unidos