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Vol. 41. Issue 10.
Pages 553-559 (October 2005)
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Vol. 41. Issue 10.
Pages 553-559 (October 2005)
Original Articles
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Cystic Fibrosis in Adults: Inter- and Intraobserver Agreement for the Brasfield and Chrispin-Norman Chest Radiography Scoring Systems and Correlation With Clinical Data and Spirometry
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V. Gutiérreza, M.J. Oliveraa, R.M. Girónb, F. Rodríguez-Salvanésb, P. Caballeroa,
Corresponding author
palomacsr@hotmail.com

Correspondence: Dra. P. Caballero. Servicio de Radiología. Hospital de la Princesa. 1.a planta. Diego de León, 62. 28006 Madrid. España
a Servicio de Radiodiagnóstico, Hospital de la Princesa, Universidad Autónoma, Madrid, Spain
b Servicio de Neumología, Hospital de la Princesa, Universidad Autónoma, Madrid, Spain
c Unidad de Epidemiología Clínica, Hospital de la Princesa, Universidad Autónoma, Madrid, Spain
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Objective

Most chest radiography scoring systems for patients with cystic fibrosis have been developed for children but are also used for adults. Our aim was to evaluate the intra- and interobserver variability of 2 radiographic scoring systems in adults with cystic fibrosis and to assess the correlation of these systems with clinical and spirometric parameters.

Patients and methods

The chest x-rays of 24 adult patients with cystic fibrosis were compared using 2 scoring systems (Brasfield and Chrispin-Norman). The x-rays were scored by 2 radiologists and reevaluated 4 months later by 1 of the 2 observers. Intra- and interobserver agreement was assessed using the intraclass and Pearson's correlation coefficients. The radiographic scores were compared to lung function tests and other clinical data.

Results

Both intra- and interobserver agreement were high (r≥0.9 and the intraclass correlation coefficient ≥0.85 with both systems for both samples). Both scoring systems correlated with spirometry results: forced expiratory volume in the first second (FEV1) (r = 0.64 and r = 0.55), FEV1% (r = 0.75 and r = 0.72), and the percentage of forced vital capacity in relation to the predicted value (r = 0.63 and r = 0.056). We found no association between scoring system and sex, age, or body mass index.

Conclusions

Assessment of chest radiographs of adult patients with cystic fibrosis by the Brasfield and Chrispin-Norman scoring systems shows good intra- and interobserver agreement. Both systems correlate well with lung function variables, especially FEV1.

Key Words:
Cystic fibrosis
Lung function tests
Intraobserver agreement
Interobserver agreement
Chest radiography scoring systems
Objetivo

La mayoría de los sistemas de puntuación para la radiografía de tórax de pacientes con fibrosis quística (FQ) se desarrollaron en niños y se utilizan en adultos. Nuestro objetivo ha sido valorar la variabilidad intra e interobservador para la radiografía de tórax en 2 sistemas de puntuación en adultos con FQ y relacionarlos con algunos parámetros clínicos y espirométricos.

Pacientes y métodos

Se han comparado las radiografías de tórax de 24 pacientes adultos con FQ mediante 2 sistemas de puntuación (Brasfield y Chrispin-Norman). Dos radiólogos clasificaron los estudios, que revaluó 4 meses después uno de los 2 observadores. Los acuerdos intra e interobservador se calcularon mediante el coeficiente de correlación de Pearson (r) y el coeficiente de correlación intraclase. Las puntuaciones de la radiografía de tórax se relacionaron con pruebas de función respiratoria y otros datos clínicos.

Resultados

LOS acuerdos intra e interobservador fueron altos (r ≥ 0,9 y coeficiente de correlación intraclase ≥ 0,85 en los 2 acuerdos para los 2 sistemas). Los 2 sistemas de puntuación mostraron correlación con los datos espirométricos: volumen espiratorio forzado en el primer segundo (FEV1; r = 0,64 y 0,55), FEV1 % (r = 0,75 y 0,72) y porcentaje sobre el valor teórico estándar de la capacidad vital forzada (r = 0,63 y 0,056). No encontramos relación de los sistemas de puntuación con el sexo, la edad ni el índice de masa corporal.

Conclusiones

La radiografía de tórax en pacientes adultos con FQ, valorada mediante los sistemas de puntuación de Brasfield y Chrispin-Norman, presenta buenos acuerdos intra e interobservador. Ambos sistemas de puntuación presentan una buena correlación con la función pulmonar, especialmente con el FEV1.

Palabras clave:
Fibrosis quística
Pruebas de función pulmonary
Acuerdo intraobservador
Acuerdo interobservador
Sistemas de puntuación en radiografía de tórax
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Red-Respira (RTIC C03/011)-SEPAR (Spanish Society of Pulmonology and Thoracic Surgery has supported this research.

Copyright © 2005. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
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