Back to Search Start Over

Training and standardization of general practitioners in the use of lung ultrasound for the diagnosis of pediatric pneumonia.

Authors :
Pervaiz F
Hossen S
Chavez MA
Miele CH
Moulton LH
McCollum ED
Roy AD
Chowdhury NH
Ahmed S
Begum N
Quaiyum A
Santosham M
Baqui AH
Checkley W
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