Jornal de pediatria · 2025
X-ray is not inferior to CT in terms of F1 score in the diagnosis of foreign body aspiration: a recall, precision and F1 score performance analysis based on bronchoscopically proven cases.
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Sarac Fatma, Yazici Mehmet
Аннотация
OBJECTIVE: In this study, we aimed to evaluate the diagnostic accuracy of X-ray and CT by using the F1 score with its non-inferiority margin in patients who underwent bronchoscopy with suspected diagnoses of foreign body aspiration (FBA).
METHODS: All children aged under 18 who underwent bronchoscopy with suspected diagnoses of FBA between June 2020 and December 2023 were included. The patient's medical records were examined retrospectively.
RESULTS: A total of 310 patients were included. Foreign bodies were most frequently located in the right main bronchus (47.52 %). The bronchoscopy (-) rate was 18 % in patients who had X-ray (+), 24 % in those who had CT (+), and 15 % in those who had X-ray (+) and CT (+). Chest x-rays were found to exhibit 42 % sensitivity, 74 % specificity, a positive predictive value (PPV) of 61 %, a negative predictive value (NPV) of 51 %, accuracy of 66 %, precision: 0.63, recall: 0.82, and F1 score: 0.71. Analysis showed that CT exhibited 82 % sensitivity, 37 % specificity, a PPV of 75 %, NPV of 47 %, an accuracy rate of 69 %, precision: 0.83, recall: 0.76, and F1 score: 0.79. In the present study, the diagnostic F1 score was calculated as 0.79 for CT and 0.71 for X-ray.
CONCLUSION: Despite a negative bronchoscopy rate of 34.83 % in this study, since the authors observed no severe complications or mortality, the authors recommend that it be performed on all patients with suspected foreign body aspiration. When a 10 % non-inferiority margin was applied, X-ray was found to be not inferior to CT in terms of F1 score.
METHODS: All children aged under 18 who underwent bronchoscopy with suspected diagnoses of FBA between June 2020 and December 2023 were included. The patient's medical records were examined retrospectively.
RESULTS: A total of 310 patients were included. Foreign bodies were most frequently located in the right main bronchus (47.52 %). The bronchoscopy (-) rate was 18 % in patients who had X-ray (+), 24 % in those who had CT (+), and 15 % in those who had X-ray (+) and CT (+). Chest x-rays were found to exhibit 42 % sensitivity, 74 % specificity, a positive predictive value (PPV) of 61 %, a negative predictive value (NPV) of 51 %, accuracy of 66 %, precision: 0.63, recall: 0.82, and F1 score: 0.71. Analysis showed that CT exhibited 82 % sensitivity, 37 % specificity, a PPV of 75 %, NPV of 47 %, an accuracy rate of 69 %, precision: 0.83, recall: 0.76, and F1 score: 0.79. In the present study, the diagnostic F1 score was calculated as 0.79 for CT and 0.71 for X-ray.
CONCLUSION: Despite a negative bronchoscopy rate of 34.83 % in this study, since the authors observed no severe complications or mortality, the authors recommend that it be performed on all patients with suspected foreign body aspiration. When a 10 % non-inferiority margin was applied, X-ray was found to be not inferior to CT in terms of F1 score.