Interobserver Variation in Applying a Radiographic Definition for Acute Respiratory Distress Syndrome (ARDS)

Study Overview
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Brief Summary
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The original American-European Consensus Conference (AECC) definition of Acute Respiratory Distress Syndrome (ARDS) required bilateral infiltrates consistent with pulmonary edema on frontal chest X-ray (CXR), but there is poor inter-observer reliability in interpreting CXR using this definition among intensivists and radiologists. As a result, the newly published Berlin definition of ARDS specified that the CXR criterion should include bilateral opacities consistent with pulmonary edema not fully explained by effusions, lobar/lung collapse, or nodules/masses on CXR. In order to improve inter-observer agreement, the panel have also developed a set of CXRs judged as consistent, inconsistent, or equivocal for the diagnosis of ARDS. The objective of this study is to investigate the impact of this training set on inter-observer reliability in applying the radiographic definition for ARDS.

Detailed Description
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The study is composed of 3 phases: Phase 1: All participants will be required to independently interpret a set of 12 CXRs, as provided by the consensus panel. The possible radiographic interpretations include consistent, inconsistent, or equivocal for the diagnosis of ARDS. Phase 2: Training materials adapted according to the recently published Berlin definition of ARDS, with its expanded rationale and interpretation of all 12 CXRs, will be sent to all participants. Phase 3: The same set of 12 CXRs, in different order, will be sent to all participants for interpretation for the second time.

Official Title
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Interobserver Variation in Applying a Radiographic Definition for ARDS: Impact of a Training Set of Berlin ARDS Definition

Conditions
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Acute Respiratory Distress Syndrome

Intervention / Treatment
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* Other: Training and education


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: intensivists working in the participating ICUs Exclusion Criteria: those who could not participate both questionnaire surveys those who have read the reference with the training set of CXRs before the study those who have already known the objective of the study
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: Training and education|nan|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| inter-observer agreement in the interpretation of CXRs for the diagnosis of ARDS |  | immediately after reading the CXRs | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Impact of the training set on the inter-observer agreement on the interpretation of CXRs |  | difference of inter-observer agreement before and after the training course | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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ARDS, Chest radiograph, Berlin Definition, Inter-observer agreement