Pediatric anesthesia & critical care
Interrater Reliability of the 2015 Pediatric Acute Lung Injury Consensus Conference Criteria for Pediatric ARDS
Authors' conclusion
The interrater reliability of the 2015 PALICC criteria for diagnosing moderate to severe PARDS in this cohort was substantial, with diagnostic disagreements commonly caused by differences in chest radiograph interpretations. Patients with cardiac disease or chronic respiratory failure were more vulnerable to diagnostic disagreements.
Study context
- Population
- Patients with acute hypoxic respiratory failure receiving invasive mechanical ventilation, admitted 2016–2021
- Participants
- 191 encounters
- Outcome
- Interrater reliability (Gwet's agreement coefficient) of the 2015 Pediatric Acute Lung Injury Consensus Conference (PALICC) criteria for moderate to severe pediatric ARDS (PARDS)
Methodological detailsretrospective review by two PICU physicians
- Retrospective review by two PICU physicians
Main finding
As reported in the abstract
Interrater reliability
Encounters with diagnostic disagreement
37
Gwet's agreement coefficient (substantial), 95% CI 0.65-0.83
0.74
Observational data: associations, not effects.
Further findings
Factors associated with disagreement
| OR (95% CI) | P value | ||
|---|---|---|---|
| Chronically ventilated | 4.66 (2.16–10.08) | P < 0.001 | |
| Primary cardiac admission diagnosis | 3.36 (1.18–9.53) | P = 0.02 | |
| Cardiothoracic surgery during admission | 4.90 (1.60–15.00) | P = 0.005 | |
| 0.050.21520Odds ratio (log scale) |
Causes of disagreement
- Different interpretations of chest radiographs
- 56.8%
- Ambiguity in origin of pulmonary edema
- 37.8%
- Unclear if current condition significantly different from baseline
- 27.0%
Reviewer diagnostic confidence
- At least moderately confident
- 73%
- Less likely to be confident with cardiac disease or chronic respiratory failure
Original publication
Interrater Reliability of the 2015 Pediatric Acute Lung Injury Consensus Conference Criteria for Pediatric ARDS. Chest. Published 14 April 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →