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Does the Lateral Chest Radiograph Help Pediatric Emergency Physicians Diagnose Pneumonia? A Randomized Clinical Trial
Author(s) -
Lynch Tim,
Gouin Serge,
Larson Charles,
Patenaude Yves
Publication year - 2004
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1197/j.aem.2003.12.019
Subject(s) - medicine , chest radiograph , pneumonia , randomized controlled trial , emergency department , radiography , emergency physician , pediatrics , emergency medicine , physical therapy , radiology , surgery , psychiatry
Objectives: To determine whether the addition of the lateral chest radiograph to the frontal view influences the pediatric emergency physician's diagnosis and management of patients with pneumonia. Methods: A randomized clinical trial was conducted, involving 570 patients, 1–16 years of age, visiting a pediatric emergency department (ED) for whom frontal and lateral chest radiographs were ordered for the clinical suspicion of pneumonia. Pediatric emergency physicians reviewed the frontal film alone in group 1 and both the frontal and the lateral films in group 2. The interpretation of each radiograph was then compared with consensus interpretation by pediatric radiologists who interpreted both views. Results: There were 604 eligible children; 34 families declined to participate. Three hundred three were randomized into group 1, whereas 267 were randomized into group 2. The clinicians' interpretations were equal in sensitivity for group 1 at 91% and 87% in group 2 (p = 0.321) and equal in specificity for group 1 at 58% and 57% in group 2 (p = 0.888). Conclusions: The addition of the lateral chest radiograph to the frontal view did not improve the sensitivity or specificity of pediatric emergency physicians in their diagnosis of pneumonia in children.