Performance of lung ultrasound in the diagnosis of pediatric pneumonia in Mozambique and Pakistan.
Performance of lung ultrasound in the diagnosis of pediatric pneumonia in Mozambique and Pakistan.
复制标题
DOI：
10.1002/ppul.25176
复制
发表时间：
2021-03
影响因子：
3.1
通讯作者：
Volpicelli G
中科院分区：
文献类型：
--
作者：
Ginsburg AS;Lenahan JL;Jehan F;Bila R;Lamorte A;Hwang J;Madrid L;Nisar MI;Vitorino P;Kanth N;Balcells R;Baloch B;May S;Valente M;Varo R;Nadeem N;Bassat Q;Volpicelli G
在低资源环境（LRS）中需要改进肺炎诊断;肺部超声（LUS）是一种有前途的肺炎诊断技术。目的是比较LUS与胸部X线片（CXR），以及LUS口译员之间，比较专家与有限培训的评估者间可靠性。我们在莫桑比克和巴基斯坦的两家地区医院对患有世界卫生组织（WHO）儿童疾病综合管理（IMCI）胸部吸入性肺炎的儿童进行了一项前瞻性观察性研究，并评估了LUS和CXR检查。主要终点是LUS和CXR判读器在WHO IMCI吸入性肺炎儿童中肺炎诊断的评估者间可靠性。专家LUS口译员的评分员间可靠性非常好，但专家CXR口译员和培训有限的现场LUS口译员的评分员间可靠性较差。在WHO IMCI内吸性肺炎患儿中，与CXR相比，专家口译员可以实现LUS的评分者间可靠性显著更高，LUS显示出作为首选参考标准的潜力。为了成功实施床旁LUS以诊断和管理LRS中的肺炎，需要了解和解决临床环境和适当的用户培训量。
Improved pneumonia diagnostics are needed in low‐resource settings (LRS); lung ultrasound (LUS) is a promising diagnostic technology for pneumonia. The objective was to compare LUS versus chest radiograph (CXR), and among LUS interpreters, to compare expert versus limited training with respect to interrater reliability. We conducted a prospective, observational study among children with World Health Organization (WHO) Integrated Management of Childhood Illness (IMCI) chest‐indrawing pneumonia at two district hospitals in Mozambique and Pakistan, and assessed LUS and CXR examinations. The primary endpoint was interrater reliability between LUS and CXR interpreters for pneumonia diagnosis among children with WHO IMCI chest‐indrawing pneumonia. Interrater reliability was excellent for expert LUS interpreters, but poor to moderate for expert CXR interpreters and onsite LUS interpreters with limited training. Among children with WHO IMCI chest‐indrawing pneumonia, expert interpreters may achieve substantially higher interrater reliability for LUS compared to CXR, and LUS showed potential as a preferred reference standard. For point‐of‐care LUS to be successfully implemented for the diagnosis and management of pneumonia in LRS, the clinical environment and amount of appropriate user training will need to be understood and addressed.
登录
查看更多内容
影响因子：
--
作者：
Hassen, Meiron;Toma, Alemayehu;Tadesse, Birkneh Tilahun
通讯作者：
Tadesse, Birkneh Tilahun
影响因子：
3.3
作者：
Nadimpalli, Adi;Tsung, James W.;Teicher, Carrie
通讯作者：
Teicher, Carrie
影响因子：
3.7
作者：
Ominde, M.;Sande, J.;Scott, A.
通讯作者：
Scott, A.
影响因子：
2.3
作者：
Stadler, Jacob A. M.;Andronikou, Savvas;Zar, Heather J.
通讯作者：
Zar, Heather J.
影响因子：
11.8
作者：
Fancourt, Nicholas;Knoll, Maria Deloria;O'Brien, Katherine L.
通讯作者：
O'Brien, Katherine L.