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Training and standardization of general practitioners in the use of lung ultrasound for the diagnosis of pediatric pneumonia.
- Source :
-
Pediatric pulmonology [Pediatr Pulmonol] 2019 Nov; Vol. 54 (11), pp. 1753-1759. Date of Electronic Publication: 2019 Aug 20. - Publication Year :
- 2019
-
Abstract
- Background: Pneumonia is a leading cause of death in children of low-resource settings. Barriers to care include an early and accurate diagnosis. Lung ultrasound is a novel tool for the identification of pediatric pneumonia; however, there is currently no standardized approach to train in image acquisition and interpretation of findings in epidemiological studies. We developed a training program for physicians with limited ultrasound experience on how to use ultrasound for the diagnosis of pediatric pneumonia and how to standardize image interpretation using a panel of readers.<br />Methods: Twenty-five physicians participating in the training program conducted lung ultrasounds in all children with suspected pneumonia, aged 3 to 35 months, presenting to three subdistrict hospitals in Sylhet, Bangladesh, between June 2015 and September 2017.<br />Results: A total of 9051 pediatric lung ultrasound assessments were conducted through 27 months of data collection. Study physicians underwent training and all were successfully standardized, achieving 91% agreement and maintained a sensitivity and specificity of 88% and 92%, respectively, when their diagnosis was compared with experts. Overall kappa between two readers was high (0.86, 95% confidence interval [CI], 0.84-0.87), and remained high when a third expert reader was included (0.80, 95% CI, 0.79-0.81). Agreement and kappa statistics were similarly high when stratified by age, sex, presence of danger signs, or hypoxemia.<br />Conclusions: Lung ultrasound is a novel tool for the diagnosis of pediatric pneumonia with evidence supporting its validity and feasibility of implementation. Here we introduced a training program that resulted in a high level of inter-sonographer agreement.<br /> (© 2019 The Authors. Pediatric Pulmonology published by Wiley Periodicals, Inc.)
Details
- Language :
- English
- ISSN :
- 1099-0496
- Volume :
- 54
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Pediatric pulmonology
- Publication Type :
- Academic Journal
- Accession number :
- 31432618
- Full Text :
- https://doi.org/10.1002/ppul.24477