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Shir A, Micha A, Novik FE, Elizabeth HS, Shani P, Maija L, Inbal R, Aviv G, Yotam D, Inbal GT. Comparison of chest X-ray interpretation by pediatric pulmonologists, pediatric radiologists, and pediatric residents in children with suspected foreign body aspiration-a retrospective cohort study. Eur J Pediatr 2023:10.1007/s00431-023-04943-z. [PMID: 37081195 DOI: 10.1007/s00431-023-04943-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/02/2023] [Accepted: 03/20/2023] [Indexed: 04/22/2023]
Abstract
Chest X-ray (CXR) is an important tool in the assessment of children with suspected foreign body aspiration (FBA), although it can falsely be interpreted as normal in one-third of the cases. The aim of this study is to evaluate the positive predictive value of CXR in children hospitalized with suspected FBA, when interpreted by three disciplines: pediatric pulmonology, pediatric radiology, and pediatric residents. This is a retrospective study that included children aged 0-18 years, admitted with suspected FBA, between 2009 and 2020 in one tertiary center. All patients underwent CXR and a flexible/rigid bronchoscopy for the definitive diagnosis of FBA, up to 1 week apart. Two physicians from each discipline interpreted the CXR, independently. Intra-raters' and inter-raters' agreements were assessed. Sensitivity, specificity, and area under the curve (AUC) were calculated for each discipline. Four hundred seventy-three children were included in the study, 175 (37%) with FBA and 298 (63%) without FBA on flexible/rigid bronchoscopy. The most common radiological findings, as interpreted by a pediatric pulmonologist, were unilateral hyperinflation (47%), radiopaque FB (37.6%), lobar atelectasis (10.3%), unilateral hyperinflation with atelectasis (3.4%), and lobar consolidation (1.7%). Intra-raters' agreement ranged from 0.744 (p < 0.001) among pediatric pulmonologists to 0.326 (p < 0.001) among pediatric radiologists. AUC for predicting FBA based on a CXR was 0.81, 0.77, and 0.7 when interpreted by pediatric pulmonologists, pediatric residents, and radiologists, respectively (p < 0.001). CONCLUSIONS CXR has a high positive predictive value and independently predicts FBA in children; however, normal CXR should not rule out FBA. Predictability is variable among different disciplines. WHAT IS KNOWN • Chest X-ray is an important tool in the assessment of children with suspected foreign body aspiration (FBA). • Chest X-ray can be interpreted as normal in one-third of the cases. WHAT IS NEW • Chest X-ray independently predicts FBA in children, with a high positive predictive value. • The ability of chest x-ray to predict FBA in children differs between pediatric residents, pediatric radiologists, and pediatric pulmonologists.
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Affiliation(s)
- Avraham Shir
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Aviram Micha
- Pediatric Pulmonary Unit, Soroka University Medical Center, Yitzhak Rager Ave, PO Box 151, Beer-Sheva, 8410101, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | | | - Hoch Sarah Elizabeth
- Department of Radiology, Samson Assuta Ashdod University Hospital, Ashdod, Israel
| | - Pozailov Shani
- Department of Pediatrics, Soroka University Medical Center, Beer-Sheva, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Levin Maija
- Department of Pediatrics, Soroka University Medical Center, Beer-Sheva, Israel
| | - Raviv Inbal
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Goldbart Aviv
- Department of Pediatrics, Soroka University Medical Center, Beer-Sheva, Israel
- Pediatric Pulmonary Unit, Soroka University Medical Center, Yitzhak Rager Ave, PO Box 151, Beer-Sheva, 8410101, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Dizitzer Yotam
- Departmant of Pediatrics, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Golan-Tripto Inbal
- Department of Pediatrics, Soroka University Medical Center, Beer-Sheva, Israel.
- Pediatric Pulmonary Unit, Soroka University Medical Center, Yitzhak Rager Ave, PO Box 151, Beer-Sheva, 8410101, Israel.
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
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Groswasser D, Waxman A, Givon M, Aviv G, Japha Y, Keil M, Folman R. Retroreflecting polarization spectroscopy enabling miniaturization. Rev Sci Instrum 2009; 80:093103. [PMID: 19791928 DOI: 10.1063/1.3213076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We describe and characterize alternative configurations for Doppler-free polarization spectroscopy. The suggested apparatus enables complete pump/probe beam overlap and allows substantial miniaturization. Its utility and performance for narrow linewidth, high-stability frequency locking is discussed for the /5S(1/2)F=2>-->/5P(3/2)F(')>D(2) transition in (87)Rb.
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Affiliation(s)
- D Groswasser
- Department of Physics and Ilse Katz Center for Meso- and Nanoscale Science and Technology, Ben-Gurion University of the Negev, P.O. Box 653, Be'er Sheva 84105, Israel.
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