A simple, valid, numerical score for grading chest x-ray severity in adult smear-positive pulmonary tuberculosis
A simple, valid, numerical score for grading chest x-ray severity in adult smear-positive pulmonary tuberculosis
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DOI：
10.1136/thx.2010.136242
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发表时间：
2010-10-01
期刊：
影响因子：
10
通讯作者：
Kelly, Paul M.
中科院分区：
文献类型：
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作者：
Ralph, Anna P.;Ardian, Muhamed;Kelly, Paul M.
背景 结核病 (TB) 临床试验中的放射学严重程度分级仍然不标准化。本研究的目的是生成并验证数字评分，用于对涂片阳性肺结核成人的胸部 X 光 (CXR) 严重程度进行分级并预测对治疗的反应。 方法 在印度尼西亚巴布亚的一家结核病诊所，对 115 名涂片阳性肺结核成人在诊断时、2 个月和 6 个月时进行了连续 CXR 检查。使用预测 2 个月痰镜检查状态的放射线检查结果来生成评分。然后在 4 年后在同一地点招募的 139 名可比较的结核病成人的第二个数据集中评估了评分的有效性。检查了 CXR 评分与其他结核严重程度测量之间的关系。 结果 受累肺部的估计比例和空洞的存在（但不是空洞大小或其他放射学检查结果）可显着预测结果，并且如果存在空洞，则将其组合得出由受累肺部百分比加上 40 给出的分数。除了预测 2 个月的结果外，评分与诊断时的痰涂片分级显着相关 (p
Background The grading of radiological severity in clinical trials in tuberculosis (TB) remains unstandardised. The aim of this study was to generate and validate a numerical score for grading chest x-ray (CXR) severity and predicting response to treatment in adults with smear-positive pulmonary TB.Methods At a TB clinic in Papua, Indonesia, serial CXRs were performed at diagnosis, 2 and 6 months in 115 adults with smear-positive pulmonary TB. Radiographic findings predictive of 2-month sputum microscopy status were used to generate a score. The validity of the score was then assessed in a second data set of 139 comparable adults with TB, recruited 4 years later at the same site. Relationships between the CXR score and other measures of TB severity were examined.Results The estimated proportion of lung affected and presence of cavitation, but not cavity size or other radiological findings, significantly predicted outcome and were combined to derive a score given by percentage of lung affected plus 40 if cavitation was present. As well as predicting 2-month outcome, scores were significantly associated with sputum smear grade at diagnosis (p