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Diagnostic accuracy of the Barr and Blethyn radiological scoring systems for childhood constipation assessed using colonic transit time as the gold standard

Lookup NU author(s): Dr Richard Lee, Bruce Jaffray


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Constipation is a common childhood symptom and abdominal radiography is advocated in diagnosis and management. To assess the reproducibility and diagnostic accuracy of the Barr and Blethyn systems for quantifying constipation on abdominal radiographs in children. Radiographs were scored by three observers of increasing radiological experience (student, junior doctor, consultant). Abdominal radiographs produced during measurement of colonic transit time (CTT) were classified as constipated or normal based on the value of the transit time, and were scored using both systems by observers blinded to the CTT. Abdominal radiographs obtained in children for reasons other than constipation were classed as normal and similarly scored. Reproducibility was measured using the kappa statistic. Diagnostic accuracy was measured using the area under the curve (AUC) for the receiver operator characteristic (ROC) curve. Using either system, scores were higher for constipated children (P

Publication metadata

Author(s): Jackson CR, Lee RE, Wylie ABZ, Adams C, Jaffray B

Publication type: Article

Publication status: Published

Journal: Pediatric Radiology

Year: 2009

Volume: 39

Issue: 7

Pages: 664-667

ISSN (print): 0301-0449

ISSN (electronic):

Publisher: Pediatric Radiology


DOI: 10.1007/s00247-009-1205-x


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