Can clinicians identify community-acquired pneumonia on ultralow-dose CT? A diagnostic accuracy study.
Scand J Trauma Resusc Emerg Med
; 32(1): 67, 2024 Aug 07.
Article
en En
| MEDLINE
| ID: mdl-39113114
ABSTRACT
BACKGROUND:
Without increasing radiation exposure, ultralow-dose computed tomography (CT) of the chest provides improved diagnostic accuracy of radiological pneumonia diagnosis compared to a chest radiograph. Yet, radiologist resources to rapidly report the chest CTs are limited. This study aimed to assess the diagnostic accuracy of emergency clinicians' assessments of chest ultralow-dose CTs for community-acquired pneumonia using a radiologist's assessments as reference standard.METHODS:
This was a cross-sectional diagnostic accuracy study. Ten emergency department clinicians (five junior clinicians, five consultants) assessed chest ultralow-dose CTs from acutely hospitalised patients suspected of having community-acquired pneumonia. Before assessments, the clinicians attended a focused training course on assessing ultralow-dose CTs for pneumonia. The reference standard was the assessment by an experienced emergency department radiologist. Primary outcome was the presence or absence of pulmonary opacities consistent with community-acquired pneumonia. Sensitivity, specificity, and predictive values were calculated using generalised estimating equations.RESULTS:
All clinicians assessed 128 ultralow-dose CTs. The prevalence of findings consistent with community-acquired pneumonia was 56%. Seventy-eight percent of the clinicians' CT assessments matched the reference assessment. Diagnostic accuracy estimates were sensitivity = 83% (95%CI 77-88), specificity = 70% (95%CI 59-81), positive predictive value = 80% (95%CI 74-84), negative predictive value = 78% (95%CI 73-82).CONCLUSION:
This study found that clinicians could assess chest ultralow-dose CTs for community-acquired pneumonia with high diagnostic accuracy. A higher level of clinical experience was not associated with better diagnostic accuracy.Palabras clave
Texto completo:
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Banco de datos:
MEDLINE
Asunto principal:
Neumonía
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Tomografía Computarizada por Rayos X
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Infecciones Comunitarias Adquiridas
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Año:
2024
Tipo del documento:
Article