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PLoS One. 2014 Aug 22;9(8):e106051. doi: 10.1371/journal.pone.0106051. eCollection 2014.

Accuracy of the interpretation of chest radiographs for the diagnosis of paediatric pneumonia.

Author information

1
Department of Paediatric Infectious Disease and Immunology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom; Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom.
2
Department of Radiology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom.
3
Department of Respiratory Paediatrics, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom.
4
Biological, Clinical and Environmental Systems Modelling Group, School of Biology, Newcastle University, Newcastle upon Tyne, United Kingdom.
5
Regional Epidemiology Unit, Public Health England North East, Newcastle upon Tyne, United Kingdom.
6
Department of Respiratory Paediatrics, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom; Biological, Clinical and Environmental Systems Modelling Group, School of Biology, Newcastle University, Newcastle upon Tyne, United Kingdom.
7
Department of Paediatrics, Sunderland Royal Hospital, Sunderland, United Kingdom.
8
Department of Paediatrics, James Cook University Hospital, Middlesbrough, United Kingdom.
9
Department of Paediatric Infectious Disease, Royal Children's Hospital, Brisbane, Queensland, Australia.

Abstract

INTRODUCTION:

World Health Organization (WHO) radiological classification remains an important entry criterion in epidemiological studies of pneumonia in children. We report inter-observer variability in the interpretation of 169 chest radiographs in children suspected of having pneumonia.

METHODS:

An 18-month prospective aetiological study of pneumonia was undertaken in Northern England. Chest radiographs were performed on eligible children aged ≤16 years with clinical features of pneumonia. The initial radiology report was compared with a subsequent assessment by a consultant cardiothoracic radiologist. Chest radiographic changes were categorised according to the WHO classification.

RESULTS:

There was significant disagreement (22%) between the first and second reports (kappa = 0.70, P<0.001), notably in those aged <5 years (26%, kappa = 0.66, P<0.001). The most frequent sources of disagreement were the reporting of patchy and perihilar changes.

CONCLUSION:

This substantial inter-observer variability highlights the need for experts from different countries to create a consensus to review the radiological definition of pneumonia in children.

PMID:
25148361
PMCID:
PMC4141860
DOI:
10.1371/journal.pone.0106051
[Indexed for MEDLINE]
Free PMC Article

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