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

  • 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.
Author:Gesche M. Voigt, Dominik ThieleORCiD, Martin WetzkeGND, Jürgen WeidemannORCiD, Patricia‐Maria Parpatt, Tobias WelteORCiDGND, Jürgen SeidenbergGND, Christian VogelbergGND, Holger KösterGND, Gernot Gerhard Ulrich RohdeORCiDGND, Christoph HärtelGND, Gesine HansenORCiDGND, Matthias KoppORCiDGND
Parent Title (English):Pediatric pulmonology
Place of publication:New York, NY
Document Type:Article
Date of Publication (online):2021/06/02
Date of first Publication:2021/06/02
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2023/02/10
Tag:antibiotic therapy; imaging; infections: pneumonia, TB, viral
Page Number:10
First Page:2676
Last Page:2685
This project was supported by the German Center for Lung Research (DZL) by funding for biosampling and infrastructure
The clinical trial was funded by the CAP-Net foundation and supported by the German Center for Lung Research (DZL).
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - CC BY-ND - Namensnennung - Keine Bearbeitungen 4.0 International