Evidence map›Paper›PMID 34519573›Full record

Observational studyRadiology2022

Chest Radiograph Scoring Alone or Combined with Other Risk Scores for Predicting Outcomes in COVID-19.

Iain Au-Yong, Yutaro Higashi, Elisabetta Giannotti, Andrew Fogarty, Joanne R Morling, Matthew Grainge, Andrea Race, Irene Juurlink, Mark Simmonds, Steve Briggs and 5 more

Erratum issuedOpen access · greenAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Radiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 28 papers.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed
6.2field-weighted citation impact, top 3% 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

28 citing papers in PubMed, 50 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 1 institution in 3 countries.

Iain Au-YongFrom the Department of Radiology, Nottingham University Hospitals National Health Service (NHS) Trust, Nottingham, England (I.A.Y., Y.H., E.G.); Respiratory Medicine (A.F.), Gastroenterology (C.J.C., T.C., J.W.), Department of Critical Care (M.S.), Department of Digital Services (I.J.), Department of Corporate Services (A.R., S.H.P.), Specialist Support Directorate (S.C.), Nottingham University Hospitals NHS Trust, Nottingham, England (J.R.M., S.B.); Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, England NG7 2UH (C.J.C.); Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham NG5 1PB, England (A.F., J.R.M., M.G., J.W., T.C.); NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, England (A.F., J.R.M., J.W., C.J.C., T.C.); and East Midlands Academic Health Science Network, University of Nottingham, Nottingham, England (J.W.).
Yutaro HigashiFrom the Department of Radiology, Nottingham University Hospitals National Health Service (NHS) Trust, Nottingham, England (I.A.Y., Y.H., E.G.); Respiratory Medicine (A.F.), Gastroenterology (C.J.C., T.C., J.W.), Department of Critical Care (M.S.), Department of Digital Services (I.J.), Department of Corporate Services (A.R., S.H.P.), Specialist Support Directorate (S.C.), Nottingham University Hospitals NHS Trust, Nottingham, England (J.R.M., S.B.); Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, England NG7 2UH (C.J.C.); Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham NG5 1PB, England (A.F., J.R.M., M.G., J.W., T.C.); NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, England (A.F., J.R.M., J.W., C.J.C., T.C.); and East Midlands Academic Health Science Network, University of Nottingham, Nottingham, England (J.W.).
Elisabetta GiannottiFrom the Department of Radiology, Nottingham University Hospitals National Health Service (NHS) Trust, Nottingham, England (I.A.Y., Y.H., E.G.); Respiratory Medicine (A.F.), Gastroenterology (C.J.C., T.C., J.W.), Department of Critical Care (M.S.), Department of Digital Services (I.J.), Department of Corporate Services (A.R., S.H.P.), Specialist Support Directorate (S.C.), Nottingham University Hospitals NHS Trust, Nottingham, England (J.R.M., S.B.); Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, England NG7 2UH (C.J.C.); Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham NG5 1PB, England (A.F., J.R.M., M.G., J.W., T.C.); NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, England (A.F., J.R.M., J.W., C.J.C., T.C.); and East Midlands Academic Health Science Network, University of Nottingham, Nottingham, England (J.W.).ORCID 0000-0001-6924-9822
Andrew FogartyFrom the Department of Radiology, Nottingham University Hospitals National Health Service (NHS) Trust, Nottingham, England (I.A.Y., Y.H., E.G.); Respiratory Medicine (A.F.), Gastroenterology (C.J.C., T.C., J.W.), Department of Critical Care (M.S.), Department of Digital Services (I.J.), Department of Corporate Services (A.R., S.H.P.), Specialist Support Directorate (S.C.), Nottingham University Hospitals NHS Trust, Nottingham, England (J.R.M., S.B.); Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, England NG7 2UH (C.J.C.); Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham NG5 1PB, England (A.F., J.R.M., M.G., J.W., T.C.); NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, England (A.F., J.R.M., J.W., C.J.C., T.C.); and East Midlands Academic Health Science Network, University of Nottingham, Nottingham, England (J.W.).ORCID 0000-0001-9426-977X
Joanne R MorlingFrom the Department of Radiology, Nottingham University Hospitals National Health Service (NHS) Trust, Nottingham, England (I.A.Y., Y.H., E.G.); Respiratory Medicine (A.F.), Gastroenterology (C.J.C., T.C., J.W.), Department of Critical Care (M.S.), Department of Digital Services (I.J.), Department of Corporate Services (A.R., S.H.P.), Specialist Support Directorate (S.C.), Nottingham University Hospitals NHS Trust, Nottingham, England (J.R.M., S.B.); Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, England NG7 2UH (C.J.C.); Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham NG5 1PB, England (A.F., J.R.M., M.G., J.W., T.C.); NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, England (A.F., J.R.M., J.W., C.J.C., T.C.); and East Midlands Academic Health Science Network, University of Nottingham, Nottingham, England (J.W.).ORCID 0000-0003-0772-2893
Matthew GraingeFrom the Department of Radiology, Nottingham University Hospitals National Health Service (NHS) Trust, Nottingham, England (I.A.Y., Y.H., E.G.); Respiratory Medicine (A.F.), Gastroenterology (C.J.C., T.C., J.W.), Department of Critical Care (M.S.), Department of Digital Services (I.J.), Department of Corporate Services (A.R., S.H.P.), Specialist Support Directorate (S.C.), Nottingham University Hospitals NHS Trust, Nottingham, England (J.R.M., S.B.); Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, England NG7 2UH (C.J.C.); Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham NG5 1PB, England (A.F., J.R.M., M.G., J.W., T.C.); NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, England (A.F., J.R.M., J.W., C.J.C., T.C.); and East Midlands Academic Health Science Network, University of Nottingham, Nottingham, England (J.W.).ORCID 0000-0001-7181-4042
Andrea RaceFrom the Department of Radiology, Nottingham University Hospitals National Health Service (NHS) Trust, Nottingham, England (I.A.Y., Y.H., E.G.); Respiratory Medicine (A.F.), Gastroenterology (C.J.C., T.C., J.W.), Department of Critical Care (M.S.), Department of Digital Services (I.J.), Department of Corporate Services (A.R., S.H.P.), Specialist Support Directorate (S.C.), Nottingham University Hospitals NHS Trust, Nottingham, England (J.R.M., S.B.); Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, England NG7 2UH (C.J.C.); Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham NG5 1PB, England (A.F., J.R.M., M.G., J.W., T.C.); NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, England (A.F., J.R.M., J.W., C.J.C., T.C.); and East Midlands Academic Health Science Network, University of Nottingham, Nottingham, England (J.W.).
Irene JuurlinkFrom the Department of Radiology, Nottingham University Hospitals National Health Service (NHS) Trust, Nottingham, England (I.A.Y., Y.H., E.G.); Respiratory Medicine (A.F.), Gastroenterology (C.J.C., T.C., J.W.), Department of Critical Care (M.S.), Department of Digital Services (I.J.), Department of Corporate Services (A.R., S.H.P.), Specialist Support Directorate (S.C.), Nottingham University Hospitals NHS Trust, Nottingham, England (J.R.M., S.B.); Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, England NG7 2UH (C.J.C.); Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham NG5 1PB, England (A.F., J.R.M., M.G., J.W., T.C.); NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, England (A.F., J.R.M., J.W., C.J.C., T.C.); and East Midlands Academic Health Science Network, University of Nottingham, Nottingham, England (J.W.).
Mark SimmondsFrom the Department of Radiology, Nottingham University Hospitals National Health Service (NHS) Trust, Nottingham, England (I.A.Y., Y.H., E.G.); Respiratory Medicine (A.F.), Gastroenterology (C.J.C., T.C., J.W.), Department of Critical Care (M.S.), Department of Digital Services (I.J.), Department of Corporate Services (A.R., S.H.P.), Specialist Support Directorate (S.C.), Nottingham University Hospitals NHS Trust, Nottingham, England (J.R.M., S.B.); Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, England NG7 2UH (C.J.C.); Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham NG5 1PB, England (A.F., J.R.M., M.G., J.W., T.C.); NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, England (A.F., J.R.M., J.W., C.J.C., T.C.); and East Midlands Academic Health Science Network, University of Nottingham, Nottingham, England (J.W.).
Steve BriggsFrom the Department of Radiology, Nottingham University Hospitals National Health Service (NHS) Trust, Nottingham, England (I.A.Y., Y.H., E.G.); Respiratory Medicine (A.F.), Gastroenterology (C.J.C., T.C., J.W.), Department of Critical Care (M.S.), Department of Digital Services (I.J.), Department of Corporate Services (A.R., S.H.P.), Specialist Support Directorate (S.C.), Nottingham University Hospitals NHS Trust, Nottingham, England (J.R.M., S.B.); Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, England NG7 2UH (C.J.C.); Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham NG5 1PB, England (A.F., J.R.M., M.G., J.W., T.C.); NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, England (A.F., J.R.M., J.W., C.J.C., T.C.); and East Midlands Academic Health Science Network, University of Nottingham, Nottingham, England (J.W.).
Simon CruikshankFrom the Department of Radiology, Nottingham University Hospitals National Health Service (NHS) Trust, Nottingham, England (I.A.Y., Y.H., E.G.); Respiratory Medicine (A.F.), Gastroenterology (C.J.C., T.C., J.W.), Department of Critical Care (M.S.), Department of Digital Services (I.J.), Department of Corporate Services (A.R., S.H.P.), Specialist Support Directorate (S.C.), Nottingham University Hospitals NHS Trust, Nottingham, England (J.R.M., S.B.); Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, England NG7 2UH (C.J.C.); Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham NG5 1PB, England (A.F., J.R.M., M.G., J.W., T.C.); NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, England (A.F., J.R.M., J.W., C.J.C., T.C.); and East Midlands Academic Health Science Network, University of Nottingham, Nottingham, England (J.W.).
Susan Hammond-PearsFrom the Department of Radiology, Nottingham University Hospitals National Health Service (NHS) Trust, Nottingham, England (I.A.Y., Y.H., E.G.); Respiratory Medicine (A.F.), Gastroenterology (C.J.C., T.C., J.W.), Department of Critical Care (M.S.), Department of Digital Services (I.J.), Department of Corporate Services (A.R., S.H.P.), Specialist Support Directorate (S.C.), Nottingham University Hospitals NHS Trust, Nottingham, England (J.R.M., S.B.); Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, England NG7 2UH (C.J.C.); Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham NG5 1PB, England (A.F., J.R.M., M.G., J.W., T.C.); NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, England (A.F., J.R.M., J.W., C.J.C., T.C.); and East Midlands Academic Health Science Network, University of Nottingham, Nottingham, England (J.W.).
Joe WestFrom the Department of Radiology, Nottingham University Hospitals National Health Service (NHS) Trust, Nottingham, England (I.A.Y., Y.H., E.G.); Respiratory Medicine (A.F.), Gastroenterology (C.J.C., T.C., J.W.), Department of Critical Care (M.S.), Department of Digital Services (I.J.), Department of Corporate Services (A.R., S.H.P.), Specialist Support Directorate (S.C.), Nottingham University Hospitals NHS Trust, Nottingham, England (J.R.M., S.B.); Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, England NG7 2UH (C.J.C.); Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham NG5 1PB, England (A.F., J.R.M., M.G., J.W., T.C.); NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, England (A.F., J.R.M., J.W., C.J.C., T.C.); and East Midlands Academic Health Science Network, University of Nottingham, Nottingham, England (J.W.).ORCID 0000-0002-1135-9356
Colin J CrooksFrom the Department of Radiology, Nottingham University Hospitals National Health Service (NHS) Trust, Nottingham, England (I.A.Y., Y.H., E.G.); Respiratory Medicine (A.F.), Gastroenterology (C.J.C., T.C., J.W.), Department of Critical Care (M.S.), Department of Digital Services (I.J.), Department of Corporate Services (A.R., S.H.P.), Specialist Support Directorate (S.C.), Nottingham University Hospitals NHS Trust, Nottingham, England (J.R.M., S.B.); Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, England NG7 2UH (C.J.C.); Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham NG5 1PB, England (A.F., J.R.M., M.G., J.W., T.C.); NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, England (A.F., J.R.M., J.W., C.J.C., T.C.); and East Midlands Academic Health Science Network, University of Nottingham, Nottingham, England (J.W.).ORCID 0000-0002-6794-6621
Timothy CardFrom the Department of Radiology, Nottingham University Hospitals National Health Service (NHS) Trust, Nottingham, England (I.A.Y., Y.H., E.G.); Respiratory Medicine (A.F.), Gastroenterology (C.J.C., T.C., J.W.), Department of Critical Care (M.S.), Department of Digital Services (I.J.), Department of Corporate Services (A.R., S.H.P.), Specialist Support Directorate (S.C.), Nottingham University Hospitals NHS Trust, Nottingham, England (J.R.M., S.B.); Translational Medical Sciences, School of Medicine, University of Nottingham, Nottingham, England NG7 2UH (C.J.C.); Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham NG5 1PB, England (A.F., J.R.M., M.G., J.W., T.C.); NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, England (A.F., J.R.M., J.W., C.J.C., T.C.); and East Midlands Academic Health Science Network, University of Nottingham, Nottingham, England (J.W.).ORCID 0000-0003-2555-2250
Nottingham University Hospitals NHS Trust · GB

Funding

Medical Research Council MR/P008348/1
6 · The paper itself

Abstract

Background Radiographic severity may help predict patient deterioration and outcomes from COVID-19 pneumonia. Purpose To assess the reliability and reproducibility of three chest radiograph reporting systems (radiographic assessment of lung edema [RALE], Brixia, and percentage opacification) in patients with proven SARS-CoV-2 infection and examine the ability of these scores to predict adverse outcomes both alone and in conjunction with two clinical scoring systems, National Early Warning Score 2 (NEWS2) and International Severe Acute Respiratory and Emerging Infection Consortium: Coronavirus Clinical Characterization Consortium (ISARIC-4C) mortality. Materials and Methods This retrospective cohort study used routinely collected clinical data of patients with polymerase chain reaction-positive SARS-CoV-2 infection admitted to a single center from February 2020 through July 2020. Initial chest radiographs were scored for RALE, Brixia, and percentage opacification by one of three radiologists. Intra- and interreader agreement were assessed with intraclass correlation coefficients. The rate of admission to the intensive care unit (ICU) or death up to 60 days after scored chest radiograph was estimated. NEWS2 and ISARIC-4C mortality at hospital admission were calculated. Daily risk for admission to ICU or death was modeled with Cox proportional hazards models that incorporated the chest radiograph scores adjusted for NEWS2 or ISARIC-4C mortality. Results Admission chest radiographs of 50 patients (mean age, 74 years ± 16 [standard deviation]; 28 men) were scored by all three radiologists, with good interreader reliability for all scores, as follows: intraclass correlation coefficients were 0.87 for RALE (95% CI: 0.80, 0.92), 0.86 for Brixia (95% CI: 0.76, 0.92), and 0.72 for percentage opacification (95% CI: 0.48, 0.85). Of 751 patients with a chest radiograph, those with greater than 75% opacification had a median time to ICU admission or death of just 1-2 days. Among 628 patients for whom data were available (median age, 76 years [interquartile range, 61-84 years]; 344 men), opacification of 51%-75% increased risk for ICU admission or death by twofold (hazard ratio, 2.2; 95% CI: 1.6, 2.8), and opacification greater than 75% increased ICU risk by fourfold (hazard ratio, 4.0; 95% CI: 3.4, 4.7) compared with opacification of 0%-25%, when adjusted for NEWS2 score. Conclusion Brixia, radiographic assessment of lung edema, and percentage opacification scores all reliably helped predict adverse outcomes in SARS-CoV-2 infection. © RSNA, 2021

Indexed as

AdultAgedAged, 80 and overCohort StudiesCOVID-19FemaleHumansLungMaleMiddle AgedPredictive Value of TestsPrognosisRadiographyReproducibility of ResultsRetrospective StudiesRisk Factors

Identifiers

PMID34519573
PMCPMC8475750
OpenAlexW3199732613

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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.