Interpretation of bedside chest X-rays in the ICU: is the radiologist still needed?

Abstract

PURPOSE To compare diagnostic accuracy of intensivists to radiologists in reading bedside chest X-rays. METHODS In a retrospective trial, 33 bedside chest X-rays were evaluated by five radiologists and five intensivists with different experience. Images were evaluated for devices and lung pathologies. Interobserver agreement and diagnostic accuracy were calculated. Computed tomography served as reference standard. RESULTS Seniors had higher diagnostic accuracy than residents (mean-ExpBSenior=1.456; mean-ExpBResident=1.635). Interobserver agreement for installations was more homogenously distributed between radiologists compared to intensivists (ExpBRad=1.204-1.672; ExpBInt=1.005-2.368). Seniors had comparable diagnostic accuracy. CONCLUSION No significant difference in diagnostic performance was seen between seniors of both disciplines, whereas the resident intensivists might still benefit from an interdisciplinary dialogue.