Risk factors for detection failures of chest radiography in diagnosing pneumonia

Sugishita, Keiji; Saito, Toshiaki; Asayama, Yukino; Iwamoto, Takashi

This study had several limitations. We did not include all patients with pneumonia admitted to our hospital, and there may have been a selection bias through including only the patients who underwent chest radiography and CT on the same day. Even performed on the same day, the time lag between the chest radiography and CT may have influenced the outcome because it is conceivable that the chest radiography findings changed from negative to positive during the few hours before the CT scan was performed. A further limitation is related to radiological diagnosis ability; only part of the chest CT image was surveyed by a radiologist from another facility, and no radiologists participated in the interpretation of the CRs. To accurately evaluate the radiographic findings, all CT images and CRs should be surveyed by two or more radiologists, and the Cohen's kappa coefficient should be calculated to measure interobserver agreement regarding the interpretation of the images. However, this was logistically difficult at our hospital.