ArticleEuropean radiology2023
Chest radiograph classification and severity of suspected COVID-19 by different radiologist groups and attending clinicians: multi-reader, multi-case study.
Article in European radiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Explained Deep Learning Framework for COVID-19 Detection in Volumetric CT Images Aligned with the British Society of Thoracic Imaging Reporting Guidance: A Pilot Study.Journal of imaging informatics in medicine · 2025Article
- Prognostic Value of the Brixia Radiological Score in COVID-19 Patients: A Retrospective Study from Romania.Tropical medicine and infectious disease · 2025Article
- Use of reporting templates for chest radiographs in a coronavirus disease 2019 context: measuring concordance of radiologists with three international templates.Journal of medical imaging (Bellingham, Wash.) · 2024Article
- Detection of Severe Lung Infection on Chest Radiographs of COVID-19 Patients: Robustness of AI Models across Multi-Institutional Data.Diagnostics (Basel, Switzerland) · 2024Article
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Authors and funding
23 authors.
Funding
Abstract
objectivesTo quantify reader agreement for the British Society of Thoracic Imaging (BSTI) diagnostic and severity classification for COVID-19 on chest radiographs (CXR), in particular agreement for an indeterminate CXR that could instigate CT imaging, from single and paired images.
methodsTwenty readers (four groups of five individuals)-consultant chest (CCR), general consultant (GCR), and specialist registrar (RSR) radiologists, and infectious diseases clinicians (IDR)-assigned BSTI categories and severity in addition to modified Covid-Radiographic Assessment of Lung Edema Score (Covid-RALES), to 305 CXRs (129 paired; 2 time points) from 176 guideline-defined COVID-19 patients. Percentage agreement with a consensus of two chest radiologists was calculated for (1) categorisation to those needing CT (indeterminate) versus those that did not (classic/probable, non-COVID-19); (2) severity; and (3) severity change on paired CXRs using the two scoring systems.
resultsAgreement with consensus for the indeterminate category was low across all groups (28-37%). Agreement for other BSTI categories was highest for classic/probable for the other three reader groups (66-76%) compared to GCR (49%). Agreement for normal was similar across all radiologists (54-61%) but lower for IDR (31%). Agreement for a severe CXR was lower for GCR (65%), compared to the other three reader groups (84-95%). For all groups, agreement for changes across paired CXRs was modest.
conclusionAgreement for the indeterminate BSTI COVID-19 CXR category is low, and generally moderate for the other BSTI categories and for severity change, suggesting that the test, rather than readers, is limited in utility for both deciding disposition and serial monitoring. KEY POINTS: • Across different reader groups, agreement for COVID-19 diagnostic categorisation on CXR varies widely. • Agreement varies to a degree that may render CXR alone ineffective for triage, especially for indeterminate cases. • Agreement for serial CXR change is moderate, limiting utility in guiding management.
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