Evidence map›Paper›PMID 32524176›Full record

ArticlePediatric radiology2020

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

Oluwatunmise A Fawole, Matthew S Kelly, Andrew P Steenhoff, Kristen A Feemster, Eric J Crotty, Mantosh S Rattan, Thuso David, Tiny Mazhani, Samir S Shah, Savvas Andronikou and 1 more

Open access · greenAbstract read
In one paragraph

Article in Pediatric radiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.2field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 7 institutions in 3 countries.

Oluwatunmise A FawolePerelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Matthew S KellyBotswana-UPenn Partnership, University of Botswana Main Campus, P.O. Box AC 157 ACH, Gaborone, Botswana.
Andrew P SteenhoffPerelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Kristen A FeemsterPerelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Eric J CrottyDepartment of Radiology and Medical Imaging, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Mantosh S RattanDepartment of Radiology and Medical Imaging, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Thuso DavidDepartment of Pediatrics and Adolescent Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana.
Tiny MazhaniDepartment of Pediatrics and Adolescent Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana.
Samir S ShahDivisions of Hospital Medicine and Infectious Diseases, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Savvas AndronikouDepartment of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Tonya Arscott-MillsPerelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. tonyaarscottmillsbup@gmail.com.
University of Botswana · BWUniversity of Cincinnati · USUniversity of Pennsylvania · USChildren's Hospital of Philadelphia · USCincinnati Children's Hospital Medical Center · USNew York University · USUniversity of Cape Town · ZA

Funding

Virus & Reservoirs CoreP30AI045008 · NIAID · UNIVERSITY OF PENNSYLVANIA · PI DAVID S METZGER · 1999 to 2026
$78.6M
Social and Behavioral Sciences CoreP30AI064518 · NIAID · DUKE UNIVERSITY · PI GEORGIA Doris TOMARAS · 2005 to 2026
$50.5M
Nasopharyngeal Microbiome and Risk of Bacterial Pathogen Colonization in InfantsK23AI135090 · NIAID · DUKE UNIVERSITY · PI KELLY, MATTHEW SCOTT · 2018 to 2022
$860k
NIAID NIH HHS K23 AI135090NIAID NIH HHS P30 AI045008NIAID NIH HHS P30 AI064518NIH HHS K23-AI135090NIH HHS P30-AI045008NIH HHS P30-AI064518
6 · The paper itself

Abstract

backgroundIn low- and middle-income countries, chest radiographs are most frequently interpreted by non-radiologist clinicians.

objectiveWe 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

methodsWe 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.

resultsTwenty-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).

conclusionNon-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.

Indexed as

Clinical CompetenceRadiography, ThoracicBotswanaDiagnosis, DifferentialDiagnostic ErrorsFemaleHumansInfantInservice TrainingMalePneumoniaQuality ImprovementRadiologyReproducibility of ResultsBotswanaChestChildrenPneumoniaRadiographyRadiologyTraining intervention

Identifiers

PMID32524176
PMCPMC7539136
OpenAlexW3033777269

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.