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Does training improve diagnostic accuracy and inter-rater agreement in applying the Berlin radiographic definition of acute respiratory distress syndrome? A multicenter prospective study.


ABSTRACT: Poor inter-rater reliability in chest radiograph interpretation has been reported in the context of acute respiratory distress syndrome (ARDS), although not for the Berlin definition of ARDS. We sought to examine the effect of training material on the accuracy and consistency of intensivists' chest radiograph interpretations for ARDS diagnosis.We conducted a rater agreement study in which 286 intensivists (residents 41.3%, junior attending physicians 35.3%, and senior attending physician 23.4%) independently reviewed the same 12 chest radiographs developed by the ARDS Definition Task Force ("the panel") before and after training. Radiographic diagnoses by the panel were classified into the consistent (n?=?4), equivocal (n?=?4), and inconsistent (n?=?4) categories and were used as a reference. The 1.5-hour training course attended by all 286 intensivists included introduction of the diagnostic rationale, and a subsequent in-depth discussion to reach consensus for all 12 radiographs.Overall diagnostic accuracy, which was defined as the percentage of chest radiographs that were interpreted correctly, improved but remained poor after training (42.0?±?14.8% before training vs. 55.3?±?23.4% after training, p?

SUBMITTER: Peng JM 

PROVIDER: S-EPMC5251343 | biostudies-literature | 2017 Jan

REPOSITORIES: biostudies-literature

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Does training improve diagnostic accuracy and inter-rater agreement in applying the Berlin radiographic definition of acute respiratory distress syndrome? A multicenter prospective study.

Peng Jin-Min JM   Qian Chuan-Yun CY   Yu Xiang-You XY   Zhao Ming-Yan MY   Li Shu-Sheng SS   Ma Xiao-Chun XC   Kang Yan Y   Zhou Fa-Chun FC   He Zhen-Yang ZY   Qin Tie-He TH   Yin Yong-Jie YJ   Jiang Li L   Hu Zhen-Jie ZJ   Sun Ren-Hua RH   Lin Jian-Dong JD   Li Tong T   Wu Da-Wei DW   An You-Zhong YZ   Ai Yu-Hang YH   Zhou Li-Hua LH   Cao Xiang-Yuan XY   Zhang Xi-Jing XJ   Sun Rong-Qing RQ   Chen Er-Zhen EZ   Du Bin B  

Critical care (London, England) 20170120 1


<h4>Background</h4>Poor inter-rater reliability in chest radiograph interpretation has been reported in the context of acute respiratory distress syndrome (ARDS), although not for the Berlin definition of ARDS. We sought to examine the effect of training material on the accuracy and consistency of intensivists' chest radiograph interpretations for ARDS diagnosis.<h4>Methods</h4>We conducted a rater agreement study in which 286 intensivists (residents 41.3%, junior attending physicians 35.3%, and  ...[more]

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