Effectiveness of Heptavalent Pneumococcal Conjugate Vaccine in Children Younger Than 5 Years of Age for Prevention of Pneumonia

作者：John R. Hansen, STEVEN B. BLACK, Henry R. Shinefield, Thomas Cherian, Jane E. Benson, BRUCE H. FIREMAN, Edwin M. Lewis, Paula Ray, Janelle Lee · 发表于：The Pediatric Infectious Disease Journal · 年份：2006 · DOI：10.1097/01.inf.0000232706.35674.2f · 被引用次数：269 · 研究领域：Pneumonia and Respiratory Infections、COVID-19 diagnosis using AI、Respiratory viral infections research

BACKGROUND: A World Health Organization (WHO) working group in 2001 developed a method for standardizing interpretation of chest radiographs in children for epidemiologic purposes. We reevaluated radiographs from the Kaiser Permanente Pneumococcal Efficacy trial using this method. METHODS: Seven-valent pneumococcal conjugate vaccine was evaluated in a randomized, controlled study including 37,868 infants. Effectiveness against pneumonia was previously evaluated using the original treating radiologist reading. There were 2841 sets of radiographs from this trial and all available radiographs were scanned and read blindly by 2 WHO crosstrained readers (A and B); discordance between the 2 primary readers was resolved through a consensus reading by an adjudicating panel of 2 radiologists. RESULTS: Of the 2841 radiographs, 2446 were available for scanning and were reviewed using WHO-defined descriptive categories. Two hundred fifty of the 2446 radiographs were read as positive by both readers. An additional 129 were read as positive by reader A only and 142 by reader B only for a total of 521 radiographs that were read as positive by one or both of the reviewers. The concordance rate between the 2 reviewers was 250 of 521 (48%). Of the 271 discordant radiographs, 45 of 129 (34.9%) of reader A and 66 of 142 (46.5%) for reader B were finalized as positive by the adjudicating panel. Overall, 361 radiographs were finalized as positive (12.7%). With these 361 images as the standard, the...