Unreliable subjective assessment of chest radiographs!
Further evidence that radiologic grading of primary graft dysfunction (PGD) after lung transplantation is often unreliable.
A recent study from Vienna(3) to evaluate interobserver variability of radiographic grading of primary graft dysfunction (PGD) after lung transplantation seems to confirm what is already known: that the grade scoring of chest radiographs is highly subjective. Five trained thoracic radiologists were asked to independently examine 1,988 postoperative chest radiographs performed at 0 to 6 hours, 24 hours, 48 hours, and 72 hours after arrival at the intensive care unit. Consensus among all five radiologists was found in only 43.0%! Not surprisingly the authors conclude, “Future revisions of the primary graft dysfunction grading should take this problem into consideration.” Radiographic data adds little to the oxygenation criteria for PGD grade and is scientifically unreliable.
3. Schwartz S et al, Interobserver variability impairs radiologic grading of primary graft dysfunction after lung transplantation. J Thorac Cardiovasc Surg. 2019 Sep;158(3):955-962.e1 (link to abstract)
Xvivo Insights PB-2019-10-13