I'm having an hard time trying to evaluate diagnostic concordance between lung biopsy histology reports and radiological findings (CT scan or XRay).. Do you know of anyone that has performed this comparison in children?
If not, how would you proceed?
if you are trying to assess diagnostic accuracty of CT and x ray in predicting gold standard biopsy diagnosis then use screening analysis , sensitivity, specificity, predictive value etc.
if you have some scoring of ct/xray and histology, use correlation and regression analysis.
Thank you James
I have no scoring of ct or Xray and I am not a radiologist.
I don't get how to get sensitivity, specificity etc from my radiology exams and histology reports..
The attached refs give more details.
Article Understanding and using sensitivity, specificity and predictive values
https://en.wikipedia.org/wiki/Sensitivity_and_specificity
Let's say you have a lung CT reporting a consolidation while histology shows a granuloma.
How would you consider it? Is it a false negative beacuse the screening test (CT) doesn't show you what the gold standard (histology) reports?
"consolidation" is not really a radiological term and this radiological diagnosis would only be made in the presence of other clinical/biochemical findings.
this is true more generally; radiology alone would rarely give a single pathological diagnosis.ie radiology alone is a not very specific test
a screening test evaluation type of study would be most meaningful in a restricted population or clinical service .
on the other hand i can think of a few examples in paediatrics where radiology gives a pathognomic finding -- eg teratoma, azygos lobe
Thank you James, this is a very restricted population we're talking about (PID patients).
In that specific scenario how would you consider "new consolidation" that turns out to be a granuloma? Is it a false negative (that's not a granuloma) or a false positive?
Let me make another example.. let's say radiology says it may be a cyst and it turns out to be a teratoma: how would you consider it?
technically these would be false negatives if you were looking to diagnose granuloma (1) or teratoma (2).
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