@article{VoigtThieleWetzkeetal.2021,
  author    = {Voigt, Gesche M. and Thiele, Dominik and Wetzke, Martin and Weidemann, J{\"u}rgen and Parpatt, Patricia-Maria and Welte, Tobias and Seidenberg, J{\"u}rgen and Vogelberg, Christian and Koster, Holger and Rohde, Gernot G. U. and H{\"a}rtel, Christoph and Hansen, Gesine and Kopp, Matthias V.},
  title     = {Interobserver agreement in interpretation of chest radiographs for pediatric community acquired pneumonia: Findings of the pedCAPNETZ-cohort},
  series = {Pediatric Pulmonology},
  volume    = {56},
  journal   = {Pediatric Pulmonology},
  number    = {8},
  doi       = {10.1002/ppul.25528},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-244705},
  pages     = {2676 -- 2685},
  year      = {2021},
  abstract  = {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.},
  language  = {en}
}
@article{MuellerHummersHillermannetal.2020,
  author    = {M{\"u}ller, Frank and Hummers, Eva and Hillermann, Nele and Dopfer, Christian and Jablonka, Alexandra and Friede, Tim and Simmenroth, Anne and Wetzke, Martin},
  title     = {Factors influencing the frequency of airway infections in underage refugees: a retrospective, cross sectional study},
  series = {International Journal of Environmental Research and Public Health},
  volume    = {17},
  journal   = {International Journal of Environmental Research and Public Health},
  number    = {18},
  issn      = {1660-4601},
  doi       = {10.3390/ijerph17186823},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-213134},
  year      = {2020},
  abstract  = {Background: Infections are a leading cause of refugee morbidity. Recent data on the rate of airway infections and factors influencing their spread in refugee reception centers is scarce. Methods: A retrospective, cross-sectional study of de-identified medical records with a focus on respiratory infections in underage refugees was conducted at two large German refugee reception centers. Results: In total, medical data from n = 10,431 refugees over an observational period of n = 819 days was analyzed. Among pediatric patients (n = 4289), 55.3\% presented at least once to the on-site medical ward with an acute respiratory infection or signs thereof. In 38.4\% of pediatric consultations, acute airway infections or signs thereof were present. Airway infections spiked during colder months and were significantly more prevalent amongst preschool and resettled children. Their frequency displayed a positive correlation with the number of refugees housed at the reception centers. Conclusions: We show that respiratory infections are a leading cause for morbidity in young refugees and that their rate is influenced age, season, status, and residential density. This illustrates the need to protect refugee children from contracting airway infections which may also reduce the spread of coronavirus disease 2019 (COVID-19) during the current pandemic.},
  language  = {en}
}