Evidence map›Paper›PMID 39398432›Full record

ArticleIJTLD open2024

External quality assurance of chest X-ray interpretation to strengthen diagnosis of childhood TB.

B F Melingui, E Leroy-Terquem, J V Taguebue, T C Eap, L Borand, C Khosa, R Moh, J Mwanga-Amumpaire, S Beneteau, M T Eang and 6 more

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In one paragraph

Article in IJTLD open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
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

16 authors.

B F MelinguiInstitut de Recherche pour le développement (IRD), University of Montpellier, Montpellier, France.
E Leroy-TerquemFrançois Quesnay Hospital, International Pulmonology Support, Mantes-la-Jolie, France.
J V TaguebueMother and Child Center, Chantal Biya Foundation, Yaoundé, Cameroon.
T C EapNational Tuberculosis Programme, Ministry of Health, Phnom Penh, Cambodia.
L BorandInstitut Pasteur of Cambodia, Epidemiology and Public Health Unit, Clinical Research Group, Phnom Penh, Cambodia.
C KhosaNational Institute of Health, Marracuene, Mozambique.
R MohProgramme d'Action Coordonné - Cote d'Ivoire, Treichville University Hospital, Abidjan, Côte d'Ivoire.
J Mwanga-AmumpaireEpicentre Mbarara Research Centre, Mbarara, Uganda.
S BeneteauInstitut de Recherche pour le développement (IRD), University of Montpellier, Montpellier, France.
M T EangNational Center for Tuberculosis and Leprosy, Ministry of Health, Phnom Penh, Cambodia.
I ManhiçaNational Tuberculosis Control Programme, Ministry of Health, Maputo, Mozambique.
A MustaphaOla During Children's Hospital, Freetown, Sierra Leone.
O MarcyUniversity of Bordeaux, Institut national de la santé et de la recherche médicale, Unité mixte de Recherche 1219, IRD, Bordeaux, France.
E WobudeyaMakerere University-Johns Hopkins University Research Collaboration Care, Kampala, Uganda.
P Y NorvalTechnical Assistance for Management, Paris, France.
M BonnetInstitut de Recherche pour le développement (IRD), University of Montpellier, Montpellier, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChest X-ray (CXR) misinterpretation negatively affects the accuracy of childhood TB diagnosis. External quality assurance (EQA) could strengthen CXR reading skills. We assessed the uptake, performance and challenges of an EQA of CXR interpretation within the childhood TB-Speed decentralisation study in six resource-limited countries.

methodsEvery quarter, TB suggestive or unreadable CXRs and 10% of remaining CXRs from children with presumptive TB were selected for blind re-reading by national re-readers. The proportion of CXRs selected for EQA and re-read assessed the uptake. The performance was assessed by the proportion of discordant interpretations and the sensitivity and specificity of clinicians' vs re-readers' interpretations. Challenges were retrieved from country reports.

resultsOf 513 eligible CXRs, 309 (60.8%) were selected for EQA and 278/309 (90.0%) re-read. The proportion of discordant interpretation was between 13/48 (27%) in Sierra Leone and 7/13 (53.8%) in Cote d'Ivoire during the first EQA and decreased after the EQAs periods in 3/5 countries. Clinician sensitivity reached 100% in all countries over EQA. Specificity ranged between 13% in Sierra Leone and 65% in Cambodia (first EQA) and increased in 4/5 countries after the EQA periods. CXR transfer and re-readers' workload were the main challenges.

conclusionEQA can enhance CXR interpretation for childhood TB diagnosis, provided operational challenges are overcome.

Indexed as

chest X-raychildrendiagnosisexternal quality assurancelimited-resources countriestuberculosis

Identifiers

PMID39398432
PMCPMC11467854

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Registered trials

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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.