A recommended method in order to interpret chest x-rays for diagnosing small size pneumothorax

Abstract

Background:Pneumothorax can be a both progressive and life threatening disorder. In this survey we evaluated the diagnostic accuracy of a recommended method for the interpretation of chest X-Rays (CXRs) compared to the common method in diagnosis of iatrogenic Pneumothorax in an emergency department.Materials and Methods:We conducted a study on 100 CXRs (31 with the diagnosis of small size pneumothorax and 69 normal) of patients who have undergone the upper central venous catheterization. CXRs were interpreted by 5 Emergency Specialists (ESs) and 5 general practitioners (GPs) separately using the conventional and recommended method. Recommended method included a 90 degree rotation against the side of chateterization in addition to using a yellow shield as the background color. Presence of pneumothorax on the CXR was confirmed by a radiologist.Results:64.5% of the CXRs with pneumothorax were correctly diagnosed by GPs and 87.7% by ESs with reutine method and 83.2% and 97.4% by recommended method, respectively (P.value<0.001). 96.8% out of all CXRs were correctly diagnosed by GPs and 99.4% by ESs by conventional method and 97.9% by GP and 99.7% by ES was correctly diagnosed using recommended method(P.value<0.001). None of the underlying variables including sex, age, underlying diseases, the side of intervention did not affect on the diagnostic accuracy in either groups (P.value>0.05).Conclusion:A significant raise was obtained in the diagnostic accuracy of CXR using the recommended method. This study can be a preliminary study to conduct further investigations in order to enhance the diagnostic accuracy of CXRs.

Comparing Interpretation of Traumatic Chest X-Ray by Emergency Medicine Specialists and Radiologists

“…Ghane et al ( 8 ) described a new interpretation method for CXR to detect small size pneumothorax; this method increased the accuracy of EPs interpretations. Indeed, such low cost methods are recommended.…”

“…Although CXR is a useful clinical imaging technique in ED, especially for the primary evaluation of traumatic patients, the diagnostic accuracy of CXRs still depends on the clinician's experience ( 8 , 9 ). Advancement in techniques and equipment of diagnostic imaging (like digitalization) was made to improve the quality of CXR, but it is too expensive to use in all health-care units.…”

“…Advancement in techniques and equipment of diagnostic imaging (like digitalization) was made to improve the quality of CXR, but it is too expensive to use in all health-care units. Since interpretation accuracy of traumatic CXR by EPs is vital, improvements in the diagnostic accuracy of CXR by developing the interpretation's technique could be more beneficial than technical improvements in the quality of CXRs ( 8 , 10 ).…”