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Table 2 Accuracy of radiographic diagnosis of acute respiratory distress syndrome among 286 participating intensivists

From: Does training improve diagnostic accuracy and inter-rater agreement in applying the Berlin radiographic definition of acute respiratory distress syndrome? A multicenter prospective study

Variables

Before training

After training

Mean difference (95%CI)

p value

All chest radiographs

 Number of correctly diagnosed cases

5.0 ± 1.8

6.6 ± 2.8

1.6 (1.2 to 2.0)

<0.001

 Overall accuracya

42.0 ± 14.8%

55.3 ± 23.4%

13.3% (10.2 to 16.5%)

<0.001

Chest radiographs consistent with ARDS

 Number of correctly diagnosed cases

2.3 ± 1.1

2.9 ± 1.1

0.6 (0.4 to 0.8)

<0.001

 Diagnostic accuracy

57.5 ± 27.5%

72.5 ± 27.5%

15.0% (10.0 to 20.0%)

<0.001

 Sensitivity

0.579 ± 0.285

0.726 ± 0.279

0.147 (0.105 to 0.188)

<0.001

 Specificity

0.734 ± 0.209

0.783 ± 0.190

0.049 (0.018 to 0.080)

0.002

 Youden’s J statistic

0.313 ± 0.347

0.509 ± 0.370

0.196 (0.140 to 0.253)

<0.001

Chest radiographs equivocal for ARDS

 Number of correctly diagnosed cases

0.9 ± 1.0

1.6 ± 1.4

0.7 (0.5 to 0.8)*

<0.001

 Diagnostic accuracy

22.5 ± 25.0%

40.0% ± 35.0%

17.5% (12.5 to 20.0%)

<0.001

 Sensitivity

0.219 ± 0.245

0.387 ± 0.339

0.168 (0.125 to 0.211)

<0.001

 Specificity

0.824 ± 0.153

0.823 ± 0.168

−0.002 (−0.025 to 0.022)

0.883

 Youden’s J statistic

0.044 ± 0.258

0.210 ± 0.407

0.166 (0.116 to 0.216)

<0.001

Chest radiographs inconsistent with ARDS

 Number of correctly diagnosed cases

1.9 ± 1.1

2.2 ± 1.2

0.3 (0.2 to 0.5)

<0.001

 Diagnostic accuracy

47.5 ± 27.5%

55.0 ± 30.0%

7.5% (5.0 to 12.5%)

<0.001

 Sensitivity

0.462 ± 0.285

0.547 ± 0.302

0.086 (0.040 to 0.131)

<0.001

 Specificity

0.572 ± 0.213

0.724 ± 0.204

0.153 (0.122 to 0.183)

<0.001

 Youden’s J statistic

0.033 ± 0.301

0.271 ± 0.418

0.238 (0.181 to 0.295)

<0.001

  1. ARDS acute respiratory distress syndrome, CI confidence interval
  2. * p = 0.026 vs. chest radiographs inconsistent with ARDS
  3. aAccuracy defined as percentage of chest radiographs interpreted correctly