KMID : 1038420200390040340
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Ultrasonography 2020 Volume.39 No. 4 p.340 ~ p.349
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Lung ultrasonography in pregnant women during the COVID-19 pandemic: an interobserver agreement study among obstetricians
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Yassa Murat
Mutlu Memis Ali Birol Pinar Kuzan Taha Yusuf Kalafat Erkan Usta Canberk Yavuz Emre Keskin Ilkhan Tug Niyazi
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Abstract
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Purpose: This study investigated interobserver agreement in lung ultrasonography (LUS) in pregnant women performed by obstetricians with different levels of expertise, with confirmation by an expert radiologist.
Methods: This prospective study was conducted at a tertiary "Coronavirus Pandemic Hospital" in April 2020. Pregnant women suspected to have coronavirus disease 2019 (COVID-19) were included. Two blinded experienced obstetricians performed LUS on pregnant women separately and noted their scores for 14 lung zones. Following a theoretical and hands-on practical course, one experienced obstetrician, two novice obstetric residents, and an experienced radiologist blindly evaluated anonymized and randomized still images and videoclips retrospectively. Weighted Cohen's kappa and Krippendorff¡¯s alpha tests were used to assess the interobserver agreement.
Results: Fifty-two pregnant women were included, with confirmed COVID-19 diagnosis rate of 82.7%. In total, 336 eligible still images and 115 videoclips were included in the final analysis. The overall weighted Cohen¡¯s kappa values ranged from 0.706 to 0.912 for the 14 lung zones. There were only seven instances of major disagreement (>1 point) in the evaluation of 14 lung zones of 52 patients (n=728). The overall agreement between the radiologist and obstetricians for the still images (Krippendorff's ¥á=0.856, 95% confidence interval [CI], 0.797 to 0.915) and videoclips (Krippendorff's ¥á=0.785; 95% CI, 0.709 to 0.861) was good.
Conclusion: The interobserver agreement between obstetricians with different levels of experience on still images and videoclips of LUS was good. Following a brief theoretical course, obstetricians' performance of LUS in pregnant women and interpretation of pre-acquired LUS images can be considered consistent.
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KEYWORD
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COVID-19, Interobserver variability, Lung ultrasound, Pregnancy, SARS-CoV-2
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