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Accepted (AM)Open Access (License Unspecified), Open
Journal article
The Inter-Rater Reliability of Pediatric Point-of-Care Lung Ultrasound Interpretation in Children With Acute Respiratory Failure
Journal of ultrasound in medicine, v 41(5), pp 1159-1167
May 2022
PMID: 34378821
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Use of point-of-care lung ultrasound (POC-LUS) has increased significantly in pediatrics yet it remains under-studied in the pediatric intensive care unit (PICU). No studies explicitly evaluate the reliability of POC-LUS artifact interpretation among critically ill children with acute respiratory failure (ARF) in the PICU. We thus designed this study to determine the inter-rater reliability of POC-LUS interpretation in pediatric ARF among pediatric intensivists trained in POC-LUS and an expert intensivist.
We compared the interpretation of lung sliding, pleural line characteristics, ultrasound artifacts, and POC-LUS diagnoses among pediatric intensivists and an expert intensivist in a cohort of children admitted to the PICU for ARF. Kappa statistics (k) adjusted for maximum attainable agreement (k/k
) were used to quantify chance-correct agreement between the pediatric intensivist and expert physician.
We enrolled 88 patients, evaluating 3 zones per hemithorax (anterior, lateral, and posterior) for lung sliding, pleural line characteristics, ultrasound artifacts, and diagnosis. There was moderate agreement between the PICU intensivist and expert-derived diagnoses with 56% observed agreement (k/k
= 0.46, 95% confidence interval [CI] 0.31-0.65). Agreement in identification of lung sliding (k = 0.19, 95% CI -0.17 to 0.56) and pleural line characteristics (k = 0.24, 95% CI 0.08-0.40) was slight and fair, respectively, while agreement in the interpretation of ultrasound artifacts ranged from moderate to substantial.
Evidence supporting the evaluation of neonatal and adult patients with POC-LUS should not be extrapolated to critically ill pediatric patients. This study adds to the evidence supporting use of POC-LUS in the PICU by demonstrating moderate agreement between PICU intensivist and expert-derived POC-LUS diagnoses.
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Details
- Title
- The Inter-Rater Reliability of Pediatric Point-of-Care Lung Ultrasound Interpretation in Children With Acute Respiratory Failure
- Creators
- Ryan L DeSanti - St. Christopher's Hospital for ChildrenEileen A Cowan - University of Wisconsin–MadisonPierre D Kory - Aurora Health CareMichael R Lasarev - University of Wisconsin–MadisonJessica Schmidt - University of Wisconsin–MadisonAwni M Al-Subu - University of Wisconsin–Madison
- Publication Details
- Journal of ultrasound in medicine, v 41(5), pp 1159-1167
- Publisher
- Wiley
- Grant note
- University of Wisconsin-Madison UL1 TR002373 / NCATS NIH HHS NCATS NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics
- Web of Science ID
- WOS:000683780600001
- Scopus ID
- 2-s2.0-85112090922
- Other Identifier
- 991019167884404721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Acoustics
- Radiology, Nuclear Medicine & Medical Imaging