PLoS ONE (Jan 2014)

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

  • Mohamed A Elemraid,
  • Michelle Muller,
  • David A Spencer,
  • Stephen P Rushton,
  • Russell Gorton,
  • Matthew F Thomas,
  • Katherine M Eastham,
  • Fiona Hampton,
  • Andrew R Gennery,
  • Julia E Clark,
  • North East of England Paediatric Respiratory Infection Study Group

DOI
https://doi.org/10.1371/journal.pone.0106051
Journal volume & issue
Vol. 9, no. 8
p. e106051

Abstract

Read online

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.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.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.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.