| Author | Boëchat, Márcia Cristina Bastos | |
| Author | Mello, Rosane Reis de | |
| Author | Dutra, Maria Virgínia Peixoto | |
| Author | Silva, Kátia Silveira da | |
| Author | Daltro, Pedro | |
| Author | MarchioriI, Edson | |
| Access date | 2011-03-27T18:38:29Z | |
| Available date | 2011-03-27T18:38:29Z | |
| Document date | 2010 | |
| Citation | BOECHAT, Márcia Cristina Bastos. Intra and interobserver reliability of the interpretation of high-resolution computed tomography on the lungs of premature infants. São Paulo Med. J., São Paulo, v. 128, n. 3, p. 130-136, maio 2010. | pt_BR |
| ISSN | 1806-9460 | |
| URI | https://www.arca.fiocruz.br/handle/icict/1766 | |
| Abstract in Portuguese | CONTEXTO E OBJETIVO: Tomografia computadorizada de alta resolução dos pulmões (TCAR) é mais sensível que radiografias para avaliar doença
pulmonar, entretanto, pouco tem sido descrito sobre a interpretação da TCAR no período neonatal ou imediatamente após. O objetivo foi avaliar a
confiabilidade na interpretação da TCAR em lactentes prematuros de muito baixo peso (LPMBP, < 1500 g).
TIPO DE ESTUDO E LOCAL: Estudo transversal sobre confiabilidade intra e interobservador da TCAR em LPMBP.
MÉTODOS: 86 LPMBP foram submetidos a TCAR. Dois radiologistas pediátricos analisaram as tomografias. A confiabilidade foi medida pela
proporção de concordância, coeficiente kappa (KC) e índices de concordância positiva e negativa.
RESULTADOS: Para o radiologista A, na confiabilidade intraobservador o KC foi 0,79 (intervalo de confiança, IC: 0,54-1.0) para exames
normais/anormais; para cada alteração tomográfica o KC variou de 0,05 a 1. Para o radiologista B, na confiabilidade intraobservador o KC foi
0,79 (IC: 0,54-1.0) para exames normais/anormais e variou de 0,37 a 0,83 para cada alteração tomográfica. Concordância interobservador
foi de 88% para exames normais/anormais e o KC foi 0,71 (IC: 0,5-0,93) e variou de 0,51-0,67 em muitos achados anormais.
CONCLUSÃO: Para exames normais/anormais, as concordâncias intra e interobservador foram substanciais. Para muitos achados tomográficos, a
concordância intraobservador variou de moderada a substancial. Nossos dados demonstram que, na prática clínica, não há razão para mais de um
avaliador das imagens tomográficas, desde que este seja bem treinado na interpretação de TCAR de LPMBP. A análise por diferentes observadores
estará reservada para pesquisa e casos difíceis no contexto clínico. | pt_BR |
| Language | eng | pt_BR |
| Publisher | Associação Paulista de Medicina | pt_BR |
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| Rights | open access | |
| Subject in Portuguese | Tomografia computadorizada por raios X | pt_BR |
| Subject in Portuguese | Prematuro | pt_BR |
| Subject in Portuguese | Pulmão | pt_BR |
| Subject in Portuguese | Displasia broncopulmonar | pt_BR |
| Subject in Portuguese | Reprodutibilidade dos testes | pt_BR |
| Subject in Portuguese | Lactente | pt_BR |
| Title | Intra and interobserver reliability of the interpretation of high-resolution computed tomography on the lungs of premature infants | pt_BR |
| Alternative title | Con abilidades intra e interobservador na interpretação da tomogra a computadorizada de alta resolução do pulmão de lactentes prematuros | pt_BR |
| Type | Article | pt_BR |
| Abstract | CONTEXT AND OBJECTIVE: High-resolution computed tomography (HRCT) of the lungs is more sensitive than radiographs for evaluating pulmonary
disease, but little has been described about HRCT interpretation during the neonatal period or shortly afterwards. The aim here was to evaluate the
reliability of the interpretation of HRCT among very low birth weight premature infants (VLBWPI; < 1500 g).
DESIGN AND SETTING: Cross-sectional study on intra and interobserver reliability of HRCT on VLBWPI.
METHODS: 86 VLBWPI underwent HRCT. Two pediatric radiologists analyzed the HRCT images. The reliability was measured by the proportion of
agreement, kappa coeficient (KC) and positive and negative agreement indices.
RESULTS: For radiologist A, the intraobserver reliability KC was 0.79 (confidence interval, CI: 0.54-1.00) for normal/abnormal examinations; for each
abnormality on CT, KC ranged from 0.05 to 1.00. For radiologist B, the intraobserver reliability KC was 0.79 (CI: 0.54-1.00) for normal/abnormal
examinations; for each abnormality on CT, KC ranged from 0.37 to 0.83. The interobserver agreement was 88% for normal/abnormal examinations
and KC was 0.71 (CI: 0.5- 0.93); for most abnormal findings, KC ranged from 0.51-0.67.
CONCLUSION: For normal/abnormal examinations, the intra and interobserver agreements were substantial. For most of the imaging findings, the
intraobserver agreement ranged from moderate to substantial. Our data demonstrate that in clinical practice, there is no reason for more than one
tomographic image evaluator, provided that this person is well trained in VLBWPI HRCT interpretation. Analysis by different observers should be
reserved for research and for dificult cases in clinical contexts. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Universidade Federal Fluminense. Niterói, RJ, Brasil. | pt_BR |
| Subject | Tomography, X-ray computed | pt_BR |
| Subject | Infant, premature | pt_BR |
| Subject | Lung | pt_BR |
| Subject | Bronchopulmonary dysplasia | pt_BR |
| Subject | Reproducibility of results | pt_BR |
| Subject | Infant | pt_BR |
