TY - JOUR
T1 - Pneumonia and ARDS in patients receiving mechanical ventilation
T2 - Diagnostic accuracy of chest radiography
AU - Winer-Muram, Helen T.
AU - Rubin, Sanford A.
AU - Ellis, James V.
AU - Jennings, S. Gregory
AU - Arheart, Kristopher L.
AU - Wunderink, Richard G.
AU - Leeper, Kenneth V.
AU - Meduri, G. Umberto
PY - 1993/8
Y1 - 1993/8
N2 - 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.
AB - 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.
KW - Lung, infection, 60.21
KW - Lung, ventilation
KW - Radiography, bedside
KW - Respiratory distress syndrome, adult (ARDS), 60.413
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U2 - 10.1148/radiology.188.2.8327701
DO - 10.1148/radiology.188.2.8327701
M3 - Article
C2 - 8327701
AN - SCOPUS:0027179181
VL - 188
SP - 479
EP - 485
JO - Radiology
JF - Radiology
SN - 0033-8419
IS - 2
ER -