A chest radiograph scoring system in patients with severe acute respiratory infection: a validation study

Details

• Alternative Title:
  BMC Med Imaging
• Personal Author:
  Taylor, Emma ; Haven, Kathryn ; Reed, Peter ; Bissielo, Ange ; Harvey, Dave ; McArthur, Colin ; Bringans, Cameron ; Freundlich, Simone ; Ingram, R. Joan H. ; Perry, David ; Wilson, Francessa ; Milne, David ; Modahl, Lucy ; Huang, Q. Sue ; Gross, Diane ; Widdowson, Marc-Alain ; Grant, Cameron C.
• Corporate Authors:
  On behalf of the SHIVERS investigation team
• Description:
  Background
  
  The term severe acute respiratory infection (SARI) encompasses a heterogeneous group of respiratory illnesses. Grading the severity of SARI is currently reliant on indirect disease severity measures such as respiratory and heart rate, and the need for oxygen or intensive care. With the lungs being the primary organ system involved in SARI, chest radiographs (CXRs) are potentially useful for describing disease severity. Our objective was to develop and validate a SARI CXR severity scoring system.
  
  Methods
  
  We completed validation within an active SARI surveillance project, with SARI defined using the World Health Organization case definition of an acute respiratory infection with a history of fever, or measured fever of ≥ 38 °C; and cough; and with onset within the last 10 days; and requiring hospital admission. We randomly selected 250 SARI cases. Admission CXR findings were categorized as: 1 = normal; 2 = patchy atelectasis and/or hyperinflation and/or bronchial wall thickening; 3 = focal consolidation; 4 = multifocal consolidation; and 5 = diffuse alveolar changes.
  
  Results
  
  Agreement between the two pediatric radiologists was very good (κ = 0.83, 95 % CI 0.65–1.00) and between the two adult radiologists was good (κ = 0.75, 95 % CI 0.57–0. 93).
  
  Conclusions
  
  This five-point CXR scoring tool, suitable for use in poorly- and well-resourced settings and by clinicians of varying experience levels, reliably describes SARI severity. The resulting numerical data enables epidemiological comparisons of SARI severity between different countries and settings.
  
  
• Subjects:
  Acute Disease Adolescent Adult Aged Child Child, Preschool Female Humans Infant Infant, Newborn Male Middle Aged Radiography, Thoracic Respiratory Tract Infections Sensitivity And Specificity Severity Of Illness Index

  More +
• Source:
  BMC Med Imaging. 15.
• Pubmed ID:
  26714630
• Pubmed Central ID:
  PMC4696329
• Document Type:
  Journal Article
• Funding:
  1U01IP000480-01/IP/NCIRD CDC HHS/United States
• Volume:
  15
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:784547bc4bb7df6b9994e3ccffdd2a10824a505d4f615f8b5d4489200270c332
• Download URL:
  https://stacks.cdc.gov/view/cdc/37705/cdc_37705_DS1.pdf
• File Type:
  [PDF - 1.05 MB ]