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Echocardiography superior to chest radiography as neonatal diagnostic screening tool
[December 22, 2005]

Echocardiography superior to chest radiography as neonatal diagnostic screening tool

(Science Letter)
Echocardiography is superior to chest radiography as a diagnostic screening tool in the evaluation of neonatal congenital heart disease.

Scientists in the United States "assessed the utility of the chest film as a screening tool for term and preterm neonates with suspected structural heart disease. Three independent observers, blinded to patient diagnosis, retrospectively evaluated the initial chest film for each of 128 consecutive neonates with suspected heart disease (gestational age, 23-42 weeks; birth weight, 500-4621 g) who had undergone both chest radiography and echocardiography."

B. Fonseca and colleagues at University of California, San Diego explained, "These evaluations were subsequently compared with the results of the respective echocardiograms, read by board-certified pediatric cardiologists blinded to the chest film and chest film interpretation. Kappa statistics demonstrated moderate correlation (0.42-0.48) among different observers in their interpretation of the chest films but poor correlation (0.15-0.34) between chest radiography and echocardiography."

Further, the researchers found that "the chest film had a low sensitivity for structural heart disease (26-59%), with a negative predictive value of 46-52%. Among neonates less than 2 kg or younger than 35 weeks of gestation, the chest film had still lower sensitivity for detecting heart disease."

"Despite agreement among observers in chest film interpretation, the chest film does not function as a screening test for neonates with suspected heart disease, particularly in small or premature neonates," wrote Fonseca and co-investigators.

"In neonates with suspected heart disease, echocardiography should be considered, even in patients with chest films that do not suggest congenital heart disease," determined the scientists.

Fonseca and colleagues published their study in Pediatric Cardiology (Chest radiography and the evaluation of the neonate for congenital heart disease. Pediatr Cardiol, 2005;26(4):367-372).

For more information, contact M.S. Sklansky, University of California San Diego, Medical Center, Dept. Pediatrics, 200 W Arbor, San Diego, CA 92103, USA.

Publisher contact information for the journal Pediatric Cardiology is: Springer, 233 Spring Street, New York, NY 10013, USA.

Keywords: San Diego, California, United States, Cardiology, Chest Radiography, Congenital Heart Disease, Diagnostics, Medical Device, Neonatal Echocardiography, Pediatric Cardiology, Screening Test.

This article was prepared by Science Letter editors from staff and other reports. Copyright 2005, Science Letter via

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