%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Kosack, C. S.
%A Spijker, S.
%A Halton, J.
%A Bonnet, Maryline
%A Nicholas, S.
%A Chetcuti, K.
%A Mesic, A.
%A Brant, W. E.
%A Joekes, E.
%A Andronikou, S.
%T Evaluation of a chest radiograph reading and recording system for tuberculosis in a HIV-positive cohort
%D 2017
%L fdi:010070188
%G ENG
%J Clinical Radiology
%@ 0009-9260
%K MYANMAR
%M ISI:000402701700017
%N 6
%P 519.e1-519.e9
%R 10.1016/j.crad.2017.01.008
%U https://www.documentation.ird.fr/hor/fdi:010070188
%> https://www.documentation.ird.fr/intranet/publi/2017/06/010070188.pdf
%V 72
%W Horizon (IRD)
%X AIM: To assess the impact of introducing a chest radiograph reading and recording system (CRRS) with a short training session, on the accuracy and inter-reader variability of tuberculosis (TB) interpretation of chest radiographs (CXRs) by a group of non-expert readers in a human immunodeficiency virus (HIV)-positive cohort. MATERIALS AND METHODS: A set of 139 CXRs was reviewed by a group of eight physicians pre- and post-intervention at two clinics in Shan State, Myanmar, providing HIV/TB diagnosis and treatment services. The results were compared against the consensus of expert radiologists for accuracy. RESULTS: Overall accuracy was similar pre- and post-intervention for most physicians with an average area under the receiver operating characteristic curve difference of 0.02 (95% confidence interval: -0.03, 0.07). The overall agreement among physicians was poor pre- and post-intervention (Fleiss k=0.35 and k=0.29 respectively). The assessment of agreement for specific disease patterns associated with active TB in HIV-infected patients showed that for intrinsically subtle findings, the agreement was generally poor but better for the more intrinsically obvious disease patterns: pleural effusion (Cohen's kappa range = 0.37-0.67) and milliary nodular pattern (Cohen's kappa range = 0.25-0.52). CONCLUSION: This study demonstrated limited impact of the introduction of a CRRS on CXR accuracy and agreement amongst non-expert readers. The role in which CXRs are used for TB diagnosis in a HIV-positive cohort in similar clinical contexts should be reviewed.
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