TY  - JOUR
A1  - Voigt, Gesche M.
A1  - Thiele, Dominik
A1  - Wetzke, Martin
A1  - Weidemann, Jürgen
A1  - Parpatt, Patricia‐Maria
A1  - Welte, Tobias
A1  - Seidenberg, Jürgen
A1  - Vogelberg, Christian
A1  - Koster, Holger
A1  - Rohde, Gernot G. U.
A1  - Härtel, Christoph
A1  - Hansen, Gesine
A1  - Kopp, Matthias V.
T1  - Interobserver agreement in interpretation of chest radiographs for pediatric community acquired pneumonia: Findings of the pedCAPNETZ‐cohort
JF  - Pediatric Pulmonology
N2  - 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.
KW  - antibiotic therapy
KW  - imaging
KW  - infections: pneumonia
KW  - TB
KW  - viral
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-244705
VL  - 56
IS  - 8
SP  - 2676
EP  - 2685
ER  -