Diagnostic accuracy of chest radiography in detecting mediastinal lymphadenopathy in suspected pulmonary tuberculosis
| dc.contributor.author | Swingler, G. H. | en |
| dc.contributor.author | du Toit, G. | en |
| dc.contributor.author | Andronikou, S. | en |
| dc.contributor.author | van der Merwe, L. | en |
| dc.contributor.author | Zar, H. J. | en |
| dc.date.accessioned | 2015-11-24T19:24:42Z | |
| dc.date.available | 2015-11-24T19:24:42Z | |
| dc.identifier.issn | 1468-2044 | - |
| dc.identifier.uri | https://olympias.lib.uoi.gr/jspui/handle/123456789/22518 | |
| dc.rights | Default Licence | - |
| dc.subject | Child, Preschool | en |
| dc.subject | Clinical Competence | en |
| dc.subject | Epidemiologic Methods | en |
| dc.subject | Female | en |
| dc.subject | Humans | en |
| dc.subject | Infant | en |
| dc.subject | Male | en |
| dc.subject | Mediastinum | en |
| dc.subject | Medical Staff, Hospital/standards | en |
| dc.subject | Observer Variation | en |
| dc.subject | Physicians, Family/standards | en |
| dc.subject | Tomography, X-Ray Computed | en |
| dc.subject | Tuberculosis, Lymph Node/*radiography | en |
| dc.subject | Tuberculosis, Pulmonary/*radiography | en |
| dc.title | Diagnostic accuracy of chest radiography in detecting mediastinal lymphadenopathy in suspected pulmonary tuberculosis | en |
| heal.abstract | OBJECTIVE: To estimate the diagnostic accuracy of chest radiography in the detection of chest lymphadenopathy in children with clinically suspected pulmonary tuberculosis. METHODS: DESIGN: Prospective cross sectional study. SETTING: A short stay ward in a children's hospital in South Africa. Patients: Consecutive children under 14 years of age admitted with suspected pulmonary tuberculosis. Diagnostic test: Antero-posterior and/or lateral chest x rays interpreted independently and blind to the reference standard by three primary care clinicians and three paediatricians, all with a special interest in tuberculosis. Reference standard: Spiral chest computed tomography (CT) with contrast injection. RESULTS: One hundred children (median age 21.5 months) were enrolled. Lymphadenopathy was present in 46 of 100 reference CT scans and judged to be present in 47.1% of x ray assessments. Overall sensitivity was 67% and specificity 59%. Primary care clinicians were more sensitive (71.5% v 63.3%, p = 0.047) and less specific (49.8% v 68.9%, p<0.001) than paediatricians. Overall accuracy was higher for the paediatricians (diagnostic odds ratio 3.83 v 2.49, p = 0.008). The addition of a lateral to an antero-posterior view did not significantly increase accuracy (diagnostic odds ratio 3.09 v 3.73, p = 0.16). Chance adjusted inter-observer agreement (kappa) varied widely between viewer pairs, but was around 30%. CONCLUSIONS: Detection of mediastinal lymphadenopathy on chest x ray to diagnose pulmonary tuberculosis in children must be interpreted with caution. Diagnostic accuracy might be improved by refining radiological criteria for lymphadenopathy. | en |
| heal.access | campus | - |
| heal.fullTextAvailability | TRUE | - |
| heal.identifier.primary | 10.1136/adc.2004.062315 | - |
| heal.identifier.secondary | http://www.ncbi.nlm.nih.gov/pubmed/16243870 | - |
| heal.identifier.secondary | http://adc.bmj.com/content/90/11/1153.full.pdf | - |
| heal.journalName | Arch Dis Child | en |
| heal.journalType | peer-reviewed | - |
| heal.language | en | - |
| heal.publicationDate | 2005 | - |
| heal.recordProvider | Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής | el |
| heal.type | journalArticle | - |
| heal.type.el | Άρθρο Περιοδικού | el |
| heal.type.en | Journal article | en |
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