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High sensitivity of chest radiograph reading by clinical officers in a tuberculosis prevalence survey.
MedLine Citation:
PMID:  22283886     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Chest radiographs (CXRs) are used in tuberculosis (TB) prevalence surveys to identify participants for bacteriological examination. Expert readers are rare in most African countries. In our survey, clinical of cers scored CXRs of 19 216 participants once. We assessed to what extent missed CXR abnormalities affected our TB prevalence estimate.
METHODS: Two experts, a radiologist and pulmonologist, independently reviewed 1031 randomly selected CXRs, mixed with lms of con rmed TB cases. CXRs with disagreement on 'any abnormality' or 'abnormality consistent with TB' were jointly reviewed during a consensus panel. We compared the nal expert and clinical of cer classifications with bacteriologically confirmed TB as the gold standard.
RESULTS: After the panel, 199 (19%) randomly selected CXRs were considered abnormal by both expert reviewers and another 82 (8%) by one reviewer. Agreement was good among the experts (κ 0.78, 95%CI 0.73-0.82) and moderate between the clinical of cers and experts (κ range 0.50-0.62). The sensitivity of 'any abnormality' was 95% for the clinical of cers and 83% and 81% for the respective experts. The speci cities were respectively 73%, 74% and 80%. TB prevalence was underestimated by 1.5-5.0%.
CONCLUSIONS: Acceptable CXR screening can be achieved with clinical of cers. Reviewing a sample of CXRs by two experts allows an assessment of prevalence underestimation.
Authors:
A H Van't Hoog; H K Meme; H van Deutekom; A M Mithika; C Olunga; F Onyino; M W Borgdorff
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease     Volume:  15     ISSN:  1815-7920     ISO Abbreviation:  Int. J. Tuberc. Lung Dis.     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2012-01-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9706389     Medline TA:  Int J Tuberc Lung Dis     Country:  France    
Other Details:
Languages:  eng     Pagination:  1308-14     Citation Subset:  IM    
Affiliation:
Kenya Medical Research Institute (KEMRI)/Centers for Disease Control and Prevention Research and Public Health Collaboration, Kisumu, Kenya; Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
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