0
Articles |

Pulmonary Embolism : Lung Scanning Interpretation: About Words

Sylvie Bastuji-Garin; Annette Schaeffer; Pierre Wolkenstein; Bertrand Godeau; Claudine Carville; Isabelle Durand-Zaleski; Michel Meignan
Author and Funding Information

Affiliations: From the Department of Public Health, Université Paris XII, Hôpital Henri-Mondor, Créteil, France,  From the Department of Internal Medicine, Université Paris XII, Hôpital Henri-Mondor, Créteil, France,  From the Department of Dermatology, Université Paris XII, Hôpital Henri-Mondor, Créteil, France,  From the Department of Cardiology, Université Paris XII, Hôpital Henri-Mondor, Créteil, France,  From the Department of Nuclear Medicine, Université Paris XII, Hôpital Henri-Mondor, Créteil, France

Dr. S. Bastuji-Garin, Département de Santé Publique, Hôpital Henri-Mondor, 94010 Créteil, Cedex, France; e-mail: sylvie.bastuji-garin@hmn.ap-hop-paris.fr


1998 by the American College of Chest Physicians


Chest. 1998;114(6):1551-1555. doi:10.1378/chest.114.6.1551
Text Size: A A A
Published online

Abstract

Objective: To assess clinicians' agreement on how they interpret lung scan reports with regard to the diagnosis of pulmonary embolism.

Design: In this prospective study, nuclear medicine physicians provided two types of reports for each lung scan: a routine descriptive report and a short form with a standardized conclusion on the likelihood of pulmonary embolism: "high probability," " no conclusion," and "diagnosis excluded." Three independent blinded senior clinicians reviewed all routine reports and chose one of the following conclusions: "high probability," "no conclusion," or "diagnosis excluded."

Setting: An acute care teaching hospital near Paris.

Subjects: Eighty-two lung scans were studied.

Main outcome measurements: Inter-clinician agreement and agreement between clinicians' conclusions and the nuclear medicine physicians' standardized reports were analyzed using the kappa index.

Results: The distribution of the clinicians' conclusions from routine reports strongly differed (p < 0.001). Agreement among the three clinicians was observed in 40.2% of the routine reports, and the inter-clinician agreement was poor to moderate (kappa range, 0.28 to 0.52). A complete agreement among the three clinicians and the nuclear medicine physicians' standardized conclusions was observed for 32.9% of the reports. The agreement between each clinician and the standardized conclusions was also poor to moderate (kappa range, 0.32 to 0.55).

Conclusion: Reading the same routine reports, clinicians reached different conclusions. Furthermore these differed greatly from the nuclear medicine physicians' standardized conclusions. These results support the notion that physicians should be given standardized reports.


Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543