Pneumonia and ARDS in patients receiving mechanical ventilation: Diagnostic accuracy of chest radiography

Helen T. Winer-Muram, Sanford A. Rubin, James V. Ellis, S. Gregory Jennings, Kristopher L. Arheart, Richard G. Wunderink, Kenneth V. Leeper, G. Umberto Meduri

Research output: Contribution to journalArticle

111 Scopus citations

Abstract

This study was done to evaluate the diagnostic accuracy of bedside chest radiography for pneumonia, adult respiratory distress syndrome (ARDS), or both in patients receiving mechanical ventilation. The series consisted of 40 patients; diagnostic accuracy was defined as the area under the receiver operating characteristic curve. Overall diagnostic accuracy for ARDS was 0.84. Overall diagnostic accuracy for pneumonia was 0.52. Review of previous radiographs and knowledge of clinical data did not enhance diagnostic accuracy for ARDS or pneumonia. Diagnostic accuracy for pneumonia was minimally reduced when ARDS was present. There was an increase in false-negative results because the diffuse areas of increased opacity in ARDS obscured the radiographic features of pneumonia. The authors conclude that chest radiography is of limited value for the diagnosis of pneumonia in patients receiving mechanical ventilation. The high false-negative and false-positive ratings for pneumonia resulted in a low diagnostic accuracy. The high diagnostic accuracy for ARDS was primarily due to the well-defined radiographic appearance of ARDS and few false-positive ratings.

Original languageEnglish (US)
Pages (from-to)479-485
Number of pages7
JournalRadiology
Volume188
Issue number2
DOIs
StatePublished - Aug 1993

Keywords

  • Lung, infection, 60.21
  • Lung, ventilation
  • Radiography, bedside
  • Respiratory distress syndrome, adult (ARDS), 60.413

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

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    Winer-Muram, H. T., Rubin, S. A., Ellis, J. V., Jennings, S. G., Arheart, K. L., Wunderink, R. G., Leeper, K. V., & Meduri, G. U. (1993). Pneumonia and ARDS in patients receiving mechanical ventilation: Diagnostic accuracy of chest radiography. Radiology, 188(2), 479-485. https://doi.org/10.1148/radiology.188.2.8327701