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Interpretation of pediatric chest radiographs by non-radiologist clinicians in Botswana using World Health Organization criteria for endpoint pneumonia.

Publication ,  Journal Article
Fawole, OA; Kelly, MS; Steenhoff, AP; Feemster, KA; Crotty, EJ; Rattan, MS; David, T; Mazhani, T; Shah, SS; Andronikou, S; Arscott-Mills, T
Published in: Pediatr Radiol
June 2020

BACKGROUND: In low- and middle-income countries, chest radiographs are most frequently interpreted by non-radiologist clinicians. OBJECTIVE: We examined the reliability of chest radiograph interpretations performed by non-radiologist clinicians in Botswana and conducted an educational intervention aimed at improving chest radiograph interpretation accuracy among non-radiologist clinicians. MATERIALS AND METHODS: We recruited non-radiologist clinicians at a referral hospital in Gaborone, Botswana, to interpret de-identified chest radiographs for children with clinical pneumonia. We compared their interpretations with those of two board-certified pediatric radiologists in the United States. We evaluated associations between level of medical training and the accuracy of chest radiograph findings between groups, using logistic regression and kappa statistics. We then developed an in-person training intervention led by a pediatric radiologist. We asked participants to interpret 20 radiographs before and immediately after the intervention, and we compared their responses to those of the facilitating radiologist. For both objectives, our primary outcome was the identification of primary endpoint pneumonia, defined by the World Health Organization as presence of endpoint consolidation or endpoint effusion. RESULTS: Twenty-two clinicians interpreted chest radiographs in the primary objective; there were no significant associations between level of training and correct identification of endpoint pneumonia; concordance between respondents and radiologists was moderate (κ=0.43). After the training intervention, participants improved agreement with the facilitating radiologist for endpoint pneumonia from fair to moderate (κ=0.34 to κ=0.49). CONCLUSION: Non-radiologist clinicians in Botswana do not consistently identify key chest radiographic findings of pneumonia. A targeted training intervention might improve non-radiologist clinicians' ability to interpret chest radiographs.

Duke Scholars

Published In

Pediatr Radiol

DOI

EISSN

1432-1998

Publication Date

June 2020

Volume

50

Issue

7

Start / End Page

913 / 922

Location

Germany

Related Subject Headings

  • Reproducibility of Results
  • Radiology
  • Radiography, Thoracic
  • Quality Improvement
  • Pneumonia
  • Nuclear Medicine & Medical Imaging
  • Male
  • Inservice Training
  • Infant
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Fawole, O. A., Kelly, M. S., Steenhoff, A. P., Feemster, K. A., Crotty, E. J., Rattan, M. S., … Arscott-Mills, T. (2020). Interpretation of pediatric chest radiographs by non-radiologist clinicians in Botswana using World Health Organization criteria for endpoint pneumonia. Pediatr Radiol, 50(7), 913–922. https://doi.org/10.1007/s00247-020-04625-0
Fawole, Oluwatunmise A., Matthew S. Kelly, Andrew P. Steenhoff, Kristen A. Feemster, Eric J. Crotty, Mantosh S. Rattan, Thuso David, et al. “Interpretation of pediatric chest radiographs by non-radiologist clinicians in Botswana using World Health Organization criteria for endpoint pneumonia.Pediatr Radiol 50, no. 7 (June 2020): 913–22. https://doi.org/10.1007/s00247-020-04625-0.
Fawole OA, Kelly MS, Steenhoff AP, Feemster KA, Crotty EJ, Rattan MS, et al. Interpretation of pediatric chest radiographs by non-radiologist clinicians in Botswana using World Health Organization criteria for endpoint pneumonia. Pediatr Radiol. 2020 Jun;50(7):913–22.
Fawole, Oluwatunmise A., et al. “Interpretation of pediatric chest radiographs by non-radiologist clinicians in Botswana using World Health Organization criteria for endpoint pneumonia.Pediatr Radiol, vol. 50, no. 7, June 2020, pp. 913–22. Pubmed, doi:10.1007/s00247-020-04625-0.
Fawole OA, Kelly MS, Steenhoff AP, Feemster KA, Crotty EJ, Rattan MS, David T, Mazhani T, Shah SS, Andronikou S, Arscott-Mills T. Interpretation of pediatric chest radiographs by non-radiologist clinicians in Botswana using World Health Organization criteria for endpoint pneumonia. Pediatr Radiol. 2020 Jun;50(7):913–922.
Journal cover image

Published In

Pediatr Radiol

DOI

EISSN

1432-1998

Publication Date

June 2020

Volume

50

Issue

7

Start / End Page

913 / 922

Location

Germany

Related Subject Headings

  • Reproducibility of Results
  • Radiology
  • Radiography, Thoracic
  • Quality Improvement
  • Pneumonia
  • Nuclear Medicine & Medical Imaging
  • Male
  • Inservice Training
  • Infant
  • Humans