Evidence map›Paper›PMID 34218365›Full record

ArticleEmergency radiology2021

Diagnostic performance of chest radiography in high COVID-19 prevalence setting: experience from a European reference hospital.

Nicola Flor, Lorenzo Saggiante, Anna Paola Savoldi, Renato Vitale, Giovanni Casazza, Paolo Villa, Anna Maria Brambilla

Abstract read
In one paragraph

Article in Emergency radiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. Entropy removal of medical diagnostics.Scientific reports · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Nicola FlorU.O. di Radiodiagnostica, Ospedale L. Sacco ASST Fatebenefratelli Sacco, Via Giovanni Battista Grassi, 74, 20157, Milan, MI, Italy. nicola.flor@unimi.it.ORCID http://orcid.org/0000-0002-5314-8944
Lorenzo SaggiantePostgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono, 7, 20122, Milan, MI, Italy.
Anna Paola SavoldiPostgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono, 7, 20122, Milan, MI, Italy.
Renato VitalePostgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono, 7, 20122, Milan, MI, Italy.
Giovanni CasazzaDipartimento di Scienze Biomediche e Cliniche "L. Sacco", Università degli Studi di, Milan, MI, Italy.
Paolo VillaU.O. di Medicina e Chirurgia d'Accettazione e d'Urgenza, Ospedale L. Sacco ASST Fatebenefratelli Sacco, Via Giovanni Battista Grassi, 74, 20157, Milan, MI, Italy.
Anna Maria BrambillaU.O. di Medicina e Chirurgia d'Accettazione e d'Urgenza, Ospedale L. Sacco ASST Fatebenefratelli Sacco, Via Giovanni Battista Grassi, 74, 20157, Milan, MI, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe study's aim is to analyse the diagnostic performance of chest radiography (CXR) in patients with suspected coronavirus disease 19 (COVID-19).

methodsWe retrospectively considered 826 consecutive patients with suspected COVID-19 presenting to our emergency department (ED) from February 21 to March 31, 2020, in a high disease prevalence setting. We enrolled patients who underwent CXR and rhino-oropharyngeal swab for real-time reverse transcription-polymerase chain reaction (rRT-PCR). CXRs were evaluated by an expert radiologist; a second independent analysis was performed by two residents in consensus. All readers, blinded to rRT-PCR results, classified CXRs positive/negative depending on presence/absence of typical findings of COVID-19, using rRT-PCR as reference standard.

resultsWe finally analysed 680 patients (median age 58); 547 (80%) tested positive for COVID-19. The diagnostic performance of CXR, interpreted by the expert reader, was as follows: sensitivity (79.0%; 95% CI: 75.3-82.3), specificity (81.2%; 95% CI: 73.5-87.5), PPV (94.5%;95% CI: 92.0-96.4), NPV (48.4%; 95% CI: 41.7-55.2), and accuracy (79.3%; 95% CI: 76.0-82.2). For the residents: sensitivity (75.1%; 95% CI: 71.2-78.7), specificity (57.9%; 95% CI: 49.9-66.4), PPV (88.0%; 95% CI: 84.7-90.8), NPV (36.2%; 95% CI: 29.7-43.0), and accuracy (71.6%; 95% CI: 68.1-75.0). We found a significant difference between the reporting sensitivity (p = 0.013) and specificity (p < 0.0001) of expert radiologist vs residents. CXR sensitivity was higher in patients with symptom onset > 5 days before ED presentation compared to ≤ 5 days (84.4% vs 70.7%).

conclusionsCXR showed a sensitivity of 79% and a specificity of 81% in diagnosing viral pneumonia in symptomatic patients with clinical suspicion of COVID-19. Further studies in lower prevalence settings are needed.

Indexed as

COVID-19HospitalsHumansMiddle AgedPrevalenceRadiographyRadiography, ThoracicRetrospective StudiesSARS-CoV-2Sensitivity and SpecificityPneumoniaRadiology/radiography

Identifiers

PMID34218365
PMCPMC8254671

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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.