Diagnostic agreement of pediatricians and radiologists on chest x-rays in pediatric emergency department

DOI: 10.4328/ACAM.20690 Received: 2021-05-05 Accepted: 2021-07-01 Published Online: 2021-07-17 Corresponding Author: Nilüfer Aylanç, Çanakkale 18 Mart University, School of Medicine, Department of Radiology, 17100 Çanakkale, Turkey. E-mail: niluferaylanc@gmail.com P: +90 286 218 00 18 GSM: +90 5058569606 F: +90 286 218 37 38 Corresponding Author ORCID ID: https://orcid.org/0000-0002-5889-9763 Abstract Aim: In this study, we aimed to investigate the diagnostic agreement on chest x-rays between pediatrician and radiologist in anatomical and pathological evaluation. Material and Methods: Chest radiographs of 700 cases from the pediatric emergency clinic were included in the study. The radiographs were evaluated by the pediatrician and radiologist as double-blind from a technical point of view (posture-position, inspiration adequacy, X-ray dose) and interpretation (hilar, mediastinal, parenchymal pathologies and cardiothoracic ratio). For results, Kappa analysis was used. Results: The mean age of the patients was 4.5 ± 4.5 (min 0-max 18) years, 335 (47.9%) were females and 365 (52.1%) were males. The diagnostic agreement was found as moderate level with adequate inspiration, optimal position, mediastinal width, and left hilar fullness; low level of disagreement was found in optimal dose, pleural fluid, consolidation, mediastinal fullness, right hilar fullness, infiltration, peribronchial thickening, reticular signs and very good agreement was found in CTR. It was statistically significant in terms of all parameters (p <0.001). Discussion: There may be differences, especially between interpretations of radiological examinations. To minimize these differences and to establish an accurate and precise diagnosis, the clinician and radiologist should have close contact. Compliance and consensus in the evaluation in the radiological assessment will help to manage the treatment process precisely and correctly.