1 búsqueda de la palabra clave 'Inter-rater variability'

Prognostic relevance and inter-observer reliability of chest-imaging in pediatric ARDS: a pediatric acute respiratory distress incidence and epidemiology (PARDIE) study / Byron Enrique Piñeres Olave  

Público ISBD Título : Prognostic relevance and inter-observer reliability of chest-imaging in pediatric ARDS: a pediatric acute respiratory distress incidence and epidemiology (PARDIE) study Tipo de documento : documento electrónico Autores : Byron Enrique Piñeres Olave, Fecha de publicación : 2020 Títulos uniformes : Intensive Care Medicine Idioma : Inglés (eng) Palabras clave : ARDS  Chest radiograph  Diagnostic accuracy  Inter-rater variability  Outcome Resumen : Purpose: Definitions of acute respiratory distress syndrome (ARDS) include radiographic criteria, but there are concerns about reliability and prognostic relevance. This study aimed to evaluate the independent relationship between chest imaging and mortality and examine the inter-rater variability of interpretations of chest radiographs (CXR) in pediatric ARDS (PARDS). Methods: Prospective, international observational study in children meeting Pediatric Acute Lung Injury Consensus Conference (PALICC) criteria for PARDS, which requires new infiltrate(s) consistent with pulmonary parenchymal disease, without mandating bilateral infiltrates. Mortality analysis focused on the entire cohort, whereas inter-observer variability used a subset of patients with blinded, simultaneous interpretation of CXRs by intensivists and radiologists. Results: Bilateral infiltrates and four quadrants of alveolar consolidation were associated with mortality on a univariable basis, using CXRs from 708 patients with PARDS. For patients on either invasive (IMV) or non-invasive ventilation (NIV) with PaO2/FiO2 (PF) ratios (or SpO2/FiO2 (SF) ratio equivalent) > 100, neither bilateral infiltrates (OR 1.3 (95% CI 0.68, 2.5), p = 0.43), nor 4 quadrants of alveolar consolidation (OR 1.6 (0.85, 3), p = 0.14) were associated with mortality. For patients with PF ≤ 100, bilateral infiltrates (OR 3.6 (1.4, 9.4), p = 0.01) and four quadrants of consolidation (OR 2.0 (1.14, 3.5), p = 0.02) were associated with higher mortality. A subset of 702 CXRs from 233 patients had simultaneous interpretations. Interobserver agreement for bilateral infiltrates and quadrants was “slight” (kappa 0.31 and 0.33). Subgroup analysis showed agreement did not differ when stratified by PARDS severity but was slightly higher for children with chronic respiratory support (kappa 0.62), NIV at PARDS diagnosis (kappa 0.53), age > 10 years (kappa 0.43) and fluid balance > 40 ml/kg (kappa 0.48). Conclusion: Bilateral infiltrates and quadrants of alveolar consolidation are associated with mortality only for those with PF ratio ≤ 100, although there is high- inter-rater variability in these chest-x ray parameters. Mención de responsabilidad : Yolanda M López-Fernández, Lincoln S Smith, Joseph G Kohne, Jason P Weinman, Vicent Modesto-Alapont, Susana B Reyes-Dominguez, Alberto Medina, Byron E Piñeres-Olave, Natalie Mahieu, Margaret J Klein, Heidi R Flori, Philippe Jouvet, Robinder G Khemani, the Pediatric Acute Respiratory Distress Syndrome Incidence and Epidemiology (PARDIE) V3 Investigators and the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network Referencia : Intensive Care Med. 2020 Jul;46(7):1382-1393. DOI (Digital Object Identifier) : 10.1007/s00134-020-06074-7 PMID : 32451578 En línea : https://link.springer.com/article/10.1007/s00134-020-06074-7 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5099 Prognostic relevance and inter-observer reliability of chest-imaging in pediatric ARDS: a pediatric acute respiratory distress incidence and epidemiology (PARDIE) study [documento electrónico] / Byron Enrique Piñeres Olave,  . - 2020. Obra : Intensive Care Medicine Idioma : Inglés (eng) Palabras clave : ARDS  Chest radiograph  Diagnostic accuracy  Inter-rater variability  Outcome Resumen : Purpose: Definitions of acute respiratory distress syndrome (ARDS) include radiographic criteria, but there are concerns about reliability and prognostic relevance. This study aimed to evaluate the independent relationship between chest imaging and mortality and examine the inter-rater variability of interpretations of chest radiographs (CXR) in pediatric ARDS (PARDS). Methods: Prospective, international observational study in children meeting Pediatric Acute Lung Injury Consensus Conference (PALICC) criteria for PARDS, which requires new infiltrate(s) consistent with pulmonary parenchymal disease, without mandating bilateral infiltrates. Mortality analysis focused on the entire cohort, whereas inter-observer variability used a subset of patients with blinded, simultaneous interpretation of CXRs by intensivists and radiologists. Results: Bilateral infiltrates and four quadrants of alveolar consolidation were associated with mortality on a univariable basis, using CXRs from 708 patients with PARDS. For patients on either invasive (IMV) or non-invasive ventilation (NIV) with PaO2/FiO2 (PF) ratios (or SpO2/FiO2 (SF) ratio equivalent) > 100, neither bilateral infiltrates (OR 1.3 (95% CI 0.68, 2.5), p = 0.43), nor 4 quadrants of alveolar consolidation (OR 1.6 (0.85, 3), p = 0.14) were associated with mortality. For patients with PF ≤ 100, bilateral infiltrates (OR 3.6 (1.4, 9.4), p = 0.01) and four quadrants of consolidation (OR 2.0 (1.14, 3.5), p = 0.02) were associated with higher mortality. A subset of 702 CXRs from 233 patients had simultaneous interpretations. Interobserver agreement for bilateral infiltrates and quadrants was “slight” (kappa 0.31 and 0.33). Subgroup analysis showed agreement did not differ when stratified by PARDS severity but was slightly higher for children with chronic respiratory support (kappa 0.62), NIV at PARDS diagnosis (kappa 0.53), age > 10 years (kappa 0.43) and fluid balance > 40 ml/kg (kappa 0.48). Conclusion: Bilateral infiltrates and quadrants of alveolar consolidation are associated with mortality only for those with PF ratio ≤ 100, although there is high- inter-rater variability in these chest-x ray parameters. Mención de responsabilidad : Yolanda M López-Fernández, Lincoln S Smith, Joseph G Kohne, Jason P Weinman, Vicent Modesto-Alapont, Susana B Reyes-Dominguez, Alberto Medina, Byron E Piñeres-Olave, Natalie Mahieu, Margaret J Klein, Heidi R Flori, Philippe Jouvet, Robinder G Khemani, the Pediatric Acute Respiratory Distress Syndrome Incidence and Epidemiology (PARDIE) V3 Investigators and the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network Referencia : Intensive Care Med. 2020 Jul;46(7):1382-1393. DOI (Digital Object Identifier) : 10.1007/s00134-020-06074-7 PMID : 32451578 En línea : https://link.springer.com/article/10.1007/s00134-020-06074-7 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5099

Reserva

Reservar este documento

Ejemplares(1)

Código de barras	Número de Ubicación	Tipo de medio	Ubicación	Sección	Estado
DD001329	AC-2020-033	Archivo digital	Producción Científica	Artículos científicos	Disponible