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Acad Emerg Med. 2004 Jun;11(6):625-9.

Does the lateral chest radiograph help pediatric emergency physicians diagnose pneumonia? A randomized clinical trial.

Author information

1
Department of Pediatrics, Children's Hospital of Western Ontario, London, Ontario, Canada. tim.lynch@lhsc.on.ca

Abstract

OBJECTIVES:

To determine whether the addition of the lateral chest radiograph to the frontal view influences the pediatric emergency physician's diagnosis and management of patients with pneumonia.

METHODS:

A randomized clinical trial was conducted, involving 570 patients, 1-16 years of age, visiting a pediatric emergency department (ED) for whom frontal and lateral chest radiographs were ordered for the clinical suspicion of pneumonia. Pediatric emergency physicians reviewed the frontal film alone in group 1 and both the frontal and the lateral films in group 2. The interpretation of each radiograph was then compared with consensus interpretation by pediatric radiologists who interpreted both views.

RESULTS:

There were 604 eligible children; 34 families declined to participate. Three hundred three were randomized into group 1, whereas 267 were randomized into group 2. The clinicians' interpretations were equal in sensitivity for group 1 at 91% and 87% in group 2 (p = 0.321) and equal in specificity for group 1 at 58% and 57% in group 2 (p = 0.888).

CONCLUSIONS:

The addition of the lateral chest radiograph to the frontal view did not improve the sensitivity or specificity of pediatric emergency physicians in their diagnosis of pneumonia in children.

PMID:
15175199
[Indexed for MEDLINE]
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