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Robust and Reproducible Quantification of the Extent of Chest Radiographic Abnormalities (And It's Free!).

Requena-Méndez A, Aldasoro E, Muñoz J, Moore DA - PLoS ONE (2015)

Bottom Line: The GIMP software was used by two independent and trained readers to estimate the extent of affected lung (expressed as a percentage of total lung area) in each radiograph and the resulting radiographic SCORE. 56 chest radiographs were included in the reading analysis.The Intraclass correlation coefficient (ICC) between the 2 observers was 0.977 (p<0.001) for the area of lung affected and was 0.955 (p<0.001) for the final score; and the kappa coefficient of Interobserver agreement for both the area of lung affected and the score were 0.9 (p<0.001) and 0.86 (p<0.001) respectively.This high level of between-observer agreement suggests that this freely available software could constitute a simple and useful tool for robust evaluation of individual and serial chest radiographs.

View Article: PubMed Central - PubMed

Affiliation: ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.

ABSTRACT

Rationale: Objective, reproducible quantification of the extent of abnormalities seen on a chest radiograph would improve the user-friendliness of a previously proposed severity scoring system for pulmonary tuberculosis and could be helpful in monitoring response to therapy, including in clinical trials.

Methods: In this study we report the development and evaluation of a simple tool using free image editing software (GIMP) to accurately and reproducibly quantify the area of affected lung on the chest radiograph of tuberculosis patients. As part of a pharmacokinetic study in Lima, Peru, a chest radiograph was performed on patients with pulmonary tuberculosis and this was subsequently photographed using a digital camera. The GIMP software was used by two independent and trained readers to estimate the extent of affected lung (expressed as a percentage of total lung area) in each radiograph and the resulting radiographic SCORE.

Results: 56 chest radiographs were included in the reading analysis. The Intraclass correlation coefficient (ICC) between the 2 observers was 0.977 (p<0.001) for the area of lung affected and was 0.955 (p<0.001) for the final score; and the kappa coefficient of Interobserver agreement for both the area of lung affected and the score were 0.9 (p<0.001) and 0.86 (p<0.001) respectively.

Conclusions: This high level of between-observer agreement suggests that this freely available software could constitute a simple and useful tool for robust evaluation of individual and serial chest radiographs.

No MeSH data available.


Related in: MedlinePlus

Intraclass correlation agreement between rater A and B.
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pone.0128044.g002: Intraclass correlation agreement between rater A and B.

Mentions: 60 participants were included in the TB – pharmacokinetic study although the CXR was only performed in 56 which were therefore included for the purpose of this study. The raw data can be found in Table C in S1 File. ICC between the 2 observers was 0.923 (0.872–0.954, p<0.001) for the determination of the total area of the lungs (pixels) of each CXR and 0.977 (0.961–0.986, p<0.001) for the area of the lung affected. ICC was 1 when the presence of cavitation was evaluated. When the final composite score was determined, the ICC between the 2 raters was 0.995 (0.991–0.997, p<0.001) (Fig 2). Kappa coefficient for IOA of the score was 0.86 (p<0.001) and when the proportion of lung affected was evaluated, kappa coefficient was 0.9 (p<0.001).


Robust and Reproducible Quantification of the Extent of Chest Radiographic Abnormalities (And It's Free!).

Requena-Méndez A, Aldasoro E, Muñoz J, Moore DA - PLoS ONE (2015)

Intraclass correlation agreement between rater A and B.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4440724&req=5

pone.0128044.g002: Intraclass correlation agreement between rater A and B.
Mentions: 60 participants were included in the TB – pharmacokinetic study although the CXR was only performed in 56 which were therefore included for the purpose of this study. The raw data can be found in Table C in S1 File. ICC between the 2 observers was 0.923 (0.872–0.954, p<0.001) for the determination of the total area of the lungs (pixels) of each CXR and 0.977 (0.961–0.986, p<0.001) for the area of the lung affected. ICC was 1 when the presence of cavitation was evaluated. When the final composite score was determined, the ICC between the 2 raters was 0.995 (0.991–0.997, p<0.001) (Fig 2). Kappa coefficient for IOA of the score was 0.86 (p<0.001) and when the proportion of lung affected was evaluated, kappa coefficient was 0.9 (p<0.001).

Bottom Line: The GIMP software was used by two independent and trained readers to estimate the extent of affected lung (expressed as a percentage of total lung area) in each radiograph and the resulting radiographic SCORE. 56 chest radiographs were included in the reading analysis.The Intraclass correlation coefficient (ICC) between the 2 observers was 0.977 (p<0.001) for the area of lung affected and was 0.955 (p<0.001) for the final score; and the kappa coefficient of Interobserver agreement for both the area of lung affected and the score were 0.9 (p<0.001) and 0.86 (p<0.001) respectively.This high level of between-observer agreement suggests that this freely available software could constitute a simple and useful tool for robust evaluation of individual and serial chest radiographs.

View Article: PubMed Central - PubMed

Affiliation: ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.

ABSTRACT

Rationale: Objective, reproducible quantification of the extent of abnormalities seen on a chest radiograph would improve the user-friendliness of a previously proposed severity scoring system for pulmonary tuberculosis and could be helpful in monitoring response to therapy, including in clinical trials.

Methods: In this study we report the development and evaluation of a simple tool using free image editing software (GIMP) to accurately and reproducibly quantify the area of affected lung on the chest radiograph of tuberculosis patients. As part of a pharmacokinetic study in Lima, Peru, a chest radiograph was performed on patients with pulmonary tuberculosis and this was subsequently photographed using a digital camera. The GIMP software was used by two independent and trained readers to estimate the extent of affected lung (expressed as a percentage of total lung area) in each radiograph and the resulting radiographic SCORE.

Results: 56 chest radiographs were included in the reading analysis. The Intraclass correlation coefficient (ICC) between the 2 observers was 0.977 (p<0.001) for the area of lung affected and was 0.955 (p<0.001) for the final score; and the kappa coefficient of Interobserver agreement for both the area of lung affected and the score were 0.9 (p<0.001) and 0.86 (p<0.001) respectively.

Conclusions: This high level of between-observer agreement suggests that this freely available software could constitute a simple and useful tool for robust evaluation of individual and serial chest radiographs.

No MeSH data available.


Related in: MedlinePlus