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Multicenter Study
. 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

Mohamed A Elemraid  1 , Michelle Muller  2 , David A Spencer  3 , Stephen P Rushton  4 , Russell Gorton  5 , Matthew F Thomas  6 , Katherine M Eastham  7 , Fiona Hampton  8 , Andrew R Gennery  1 , Julia E Clark  9 ; North East of England Paediatric Respiratory Infection Study Group
Affiliations
Multicenter Study

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

Mohamed A Elemraid et al. PLoS One. .

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.

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Conflict of interest statement

Competing Interests: JEC and DAS received unconditional research support from Pfizer. The remaining authors declare no competing financial interests. This does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials.

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