Diagnosing pulmonary edema

• DOI: 10.1097/mej.0b013e32835c2b88
• Publication Date: 2012-12-22T13:11:46Z
• Authors: Jennifer L. Marti...; Vicki E. Noble; Andrew Liteplo
• Keywords: Chest radiograph; Gold standard (test); Lung Ultrasound

Background Diagnosing the underlying cause of acute dyspnea can be challenging. Lung ultrasound may help to identify pulmonary edema as a possible cause. Objective To evaluate ability residents recognize on lung using chest radiographs comparison standard. Methods This is prospective, blinded, observational study convenience sample resident physicians in Departments Emergency Medicine (EM), Internal (IM), and Radiology. Residents were given tutorial interpreting both radiograph ultrasound. They then shown ultrasounds from 20 patients who had presented emergency department with dyspnea, 10 primary diagnosis edema, alternative diagnoses. Cohen's κ values calculated describe strength correlation between gold standard interpretations. Results Participants included EM, IM, Radiology residents. The overall agreement interpretation (74%, κ=0.51, 95% confidence interval 0.46–0.55) was superior (58%, κ=0.25, 0.20–0.30) (P<0.0001). EM interpreted more accurately than IM did Conclusion able radiograph. Physicians minimal exposure correctly