Initial Results of the Use of a Standardized Diagnostic Criteria for Chest Computed Tomography Findings in Coronavirus Disease 2019

Santos, João Manoel Miranda Magalhães; Fonseca, Ana Paula Alves; Anastacio, Eduardo Pinheiro Zarattini; Minenelli, Fernanda; Cavalcanti, Conrado Furtado de Albuquerque; Teles, Gustavo Borges da Silva

doi:10.1097/rct.0000000000001054

Cited by 15 publications

(17 citation statements)

References 7 publications

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“…There was no risk of bias with regard to patient selection in the other studies or with regard to index test. Risk of bias with respect to reference test was rated high in three studies ( 23 , 26 , 27 ) because repeated RT-PCR testing was not used in all patients with a negative initial RT-PCR result and persistent clinical suspicion of COVID-19. Risk of bias with respect to reference test was rated unclear in one study ( 21 ), because it was not clear whether all patients with an initial negative RT-PCR result and a persistent clinical suspicion of COVID-19 underwent repeated RT-PCR testing.…”

Section: Resultsmentioning

confidence: 99%

“…In our current meta-analysis, the "reference standard" was the only QUADAS-2 item which was deemed to be of high risk of bias. This item applied to three of the nine included studies (33%) because repeated RT-PCR testing was not used in all patients with a negative initial RT-PCR result and persistent clinical suspicion of COVID-19 ( 23 , 26 , 27 ).…”

Section: Discussionmentioning

confidence: 99%

“…First, the included studies used RT-PCR, which is an imperfect reference standard with a reported sensitivity of 89% (95% CI: 81, 94) ( 31 ). Sensitivity of RT-PCR appears to be lower in elderly patients ( 31 ), which may be due to sampling error in these patients who are more likely to have poorer performance status ( 26 ). Furthermore, vendor-specific effects and differences in the quality assurance process may affect the performance of RT-PCR ( 31 ).…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic Performance of CO-RADS and the RSNA Classification System in Evaluating COVID-19 at Chest CT: A Meta-Analysis

Kwee

Adams

Kwee

2021

Radiology: Cardiothoracic Imaging

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Diagnostic Performance of CO-RADS and the RSNA Classification System in Evaluating COVID-19 at Chest CT: A Meta-Analysis

Kwee

Adams

Kwee

2021

Radiology: Cardiothoracic Imaging

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“…Initial studies evaluating chest computed tomography (CT) findings in patients with coronavirus disease (COVID-19) showed a high sensitivity of 94% but a low specificity of 37% (1). However, during the COVID-19 pandemic two classifications for chest CT findings were developed (2,3) -COVID-19 Reporting and Data System (CORADS) and Radiological Society of North America Expert Consensus Statement on Reporting Chest CT Findings Related to COVID-19 (RSNA)which have a high sensitivity and high specificity, even in the Brazilian population (4)(5)(6)(7)(8)(9). In addition, chest CT has proven useful in the initial evaluation of patients, not only because of its rapid results, as it detects changes suggestive of infection in minutes in contrast to reverse transcriptase-polymerase chain reaction (RT-PCR) and serological tests, which can sometimes take days, but also because of its capacity to assess the initial extent of disease, information that can be used as a tool in initial decision-making and that is correlated with prognosis (10,11).…”

Section: ' Introductionmentioning

confidence: 99%

Evaluation of the RSNA and CORADS classifications for COVID-19 on chest computed tomography in the Brazilian population

Fonseca

Loureiro

Strabelli

et al. 2021

Clinics

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To determine the correlation between the two tomographic classifications for coronavirus disease (COVID-19), COVID-19 Reporting and Data System (CORADS) and Radiological Society of North America Expert Consensus Statement on Reporting Chest Computed Tomography (CT) Findings Related to COVID-19 (RSNA), in the Brazilian population and to assess the agreement between reviewers with different experience levels. METHODS: Chest CT images of patients with reverse transcriptase-polymerase chain reaction (RT-PCR)-positive COVID-19 were categorized according to the CORADS and RSNA classifications by radiologists with different levels of experience and who were initially unaware of the RT-PCR results. The inter-and intra-observer concordances for each of the classifications were calculated, as were the concordances between classifications. RESULTS: A total of 100 patients were included in this study. The RSNA classification showed an almost perfect inter-observer agreement between reviewers with similar experience levels, with a kappa coefficient of 0.892 (95% confidence interval [CI], 0.788-0.995). CORADS showed substantial agreement among reviewers with similar experience levels, with a kappa coefficient of 0.642 (95% CI, 0.491-0.793). There was inter-observer variation when comparing less experienced reviewers with more experienced reviewers, with the highest kappa coefficient of 0.396 (95% CI, 0.255-0.588). There was a significant correlation between both classifications, with a Kendall coefficient of 0.899 (po0.001) and substantial intra-observer agreement for both classifications. CONCLUSION: The RSNA and CORADS classifications showed excellent inter-observer agreement for reviewers with the same level of experience, although the agreement between less experience reviewers and the reviewer with the most experience was only reasonable. Combined analysis of both classifications with the first RT-PCR results did not reveal any false-negative results for detecting COVID-19 in patients.

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“…Numerous articles examining the diagnostic performance of a chest CT in COVID-19 pneumonia are available in the literature. 9–14 However, there are limited articles examining the inter-observer agreement among the evaluators on this matter 10,11 and articles about the comparison of radiologists and clinicians are not present.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of the coronavirus disease 2019 with chest computed tomography: A retrospective inter-observer agreement study between radiologists and clinicians

Çengel

Gürkan

Çalık

et al. 2020

Hong Kong Journal of Emergency Medicine

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Background: Effective triage and early detection are very important for the control and treatment of coronavirus disease 2019. For this purpose, reverse transcription polymerase chain reaction and chest computed tomography are used in emergency departments. Objective: The aim of the study was to examine the diagnostic performance of computed tomography and to compare the inter-observer agreement among radiologists and between clinicians, in a coronavirus disease 2019 pneumonia high-prevalence area. Methods: After exclusions, 534 patients were retrospectively included in this study. Reverse transcription polymerase chain reaction was considered as gold standard for diagnosis. All computed tomography images were independently reviewed by two radiologists who were blinded to reverse transcription polymerase chain reaction results and other clinical information. Each computed tomography scan was scored in four categories as typical, intermediate, atypical, and negative, regarding coronavirus disease 2019 pneumonia according to Radiological Society of North America guideline. As for the evaluation of the diagnostic performance, typical and intermediate appearances were accepted as positive for coronavirus disease 2019. In addition, the computed tomography scans were scored by two clinicians as coronavirus disease 2019 positive and negative. Results: The study group included 534 patients after the exclusion criteria. As a result of the repeated reverse transcription polymerase chain reaction tests, 396 (74%) patients were diagnosed with coronavirus disease 2019, 138 (26%) patients had a negative result and were evaluated as a control group. When the reverse transcription polymerase chain reaction results were referenced as the gold standard; the accuracy rates of radiologists and clinicians (R1, R2, C1, and C2) in the diagnosis of coronavirus disease 2019 were 78%, 79%, 73%, and 71%, their sensitivity rates were 83%, 83%, 74%, and 75%, and the negative predictive values were 57%, 58%, 49%, and 46%, respectively. Inter-observer agreements among the reviewers ranged from good to excellent. Conclusions: Radiological Society of North America guideline related to coronavirus disease 2019 has excellent inter-observer agreement among chest radiologists. In this study, radiologists and clinicians have presented similar and good diagnostic performances in the evaluation of coronavirus disease 2019–suspected patients with chest computed tomography in high-epidemic area.

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Initial Results of the Use of a Standardized Diagnostic Criteria for Chest Computed Tomography Findings in Coronavirus Disease 2019

Cited by 15 publications

References 7 publications

Diagnostic Performance of CO-RADS and the RSNA Classification System in Evaluating COVID-19 at Chest CT: A Meta-Analysis

Diagnostic Performance of CO-RADS and the RSNA Classification System in Evaluating COVID-19 at Chest CT: A Meta-Analysis

Evaluation of the RSNA and CORADS classifications for COVID-19 on chest computed tomography in the Brazilian population

Diagnosis of the coronavirus disease 2019 with chest computed tomography: A retrospective inter-observer agreement study between radiologists and clinicians

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