Chest
Clinical Investigations: InfectionInterobserver Reliability of the Chest Radiograph in Community-Acquired Pneumonia
Section snippets
MATERIALS AND METHODS
This study of the interobserver reliability of the chest radiograph was conducted as part of the Pneumonia Patient Outcomes Research Team multicenter, prospective cohort study of medical outcomes in ambulatory and hospitalized patients with CAP.15
Patient Characteristics
Table 1 shows the patient characteristics for the 282 patients whose radiographs were reviewed by two radiologists in this study. The mean patient age was 53.7 years (range, 18 to 99 years), and 56.7% were female. In total, 63 (22.3%) radiographs were from patients enrolled in Pittsburgh, 87 (30.9%) from Boston, and 132 (46.8%) from Halifax. More than two thirds of patients (70.2%) were classified as low risk, and more than half (53.2%) were treated in the outpatient setting. Overall, 60% of
DISCUSSION
Detection of an acute radiographic pulmonary infiltrate by a radiologist in an ambulatory patient with acute respiratory symptoms or signs is considered virtually diagnostic of CAP, yet limited information on the interobserver reliability of this radiographic finding exists in patients with this illness. This study demonstrated that among patients with suspected CAP, the interobserver reliability of two university staff radiologists was fair to good for the detection of a pulmonary radiographic
ACKNOWLEDGMENTS
The other investigators in the Pneumonia Patient Outcomes Research Team (PORT) who played an integral role in this investigation were Thomas J. Marrie, MD, Christopher M. Coley, MD, and Daniel E. Singer, MD.
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This work was supported by a grant from the Agency for Health Care Policy and Research (grant HS-06468). Dr. Fine is supported as a Robert Wood Johnson Foundation Generalist Physician Faculty Scholar.