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Accuracy of the Interpretation of Chest Radiographs for the Diagnosis of Paediatric Pneumonia

Lookup NU author(s): Dr Mohamed Elemraid, Dr Michelle Muller, Dr David Spencer, Professor Stephen Rushton, Dr Matthew Thomas, Dr Katherine Eastham, Dr Fiona Hampton, Professor Andrew GenneryORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


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.

Publication metadata

Author(s): Elemraid MA, Muller M, Spencer DA, Rushton SP, Gorton R, Thomas MF, Eastham KM, Hampton F, Gennery AR, Clark JE, North East England Paediat Resp In

Publication type: Article

Publication status: Published

Journal: PLoS One

Year: 2014

Volume: 9

Issue: 8

Online publication date: 22/08/2014

Acceptance date: 29/07/2014

Date deposited: 30/10/2014

ISSN (electronic): 1932-6203

Publisher: Public Library of Science


DOI: 10.1371/journal.pone.0106051


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