TY - JOUR T1 - Diagnostic performance of the RSNA-proposed classification for COVID-19 pneumonia versus pre-pandemic controls JO - The Brazilian Journal of Infectious Diseases T2 - AU - Rocha,Cauã O. AU - Prioste,Tássia A.D. AU - Faccin,Carlo S. AU - Folador,Luciano AU - Tonetto,Mateus S. AU - Knijnik,Pedro G. AU - Mainardi,Natalia B. AU - Borges,Rogério B. AU - Garcia,Tiago S. SN - 14138670 M3 - 10.1016/j.bjid.2021.101665 DO - 10.1016/j.bjid.2021.101665 UR - https://www.bjid.org.br/en-diagnostic-performance-rsna-proposed-classification-for-articulo-S1413867021001343 AB - ObjectiveTo evaluate the diagnostic accuracy of the Radiological Society of North America (RSNA) classification system for coronavirus disease 2019 (COVID-19) pneumonia compared to pre-pandemic chest computed tomography (CT) scan images to mitigate the risk of bias regarding the reference standard. Materials and methodsThis was a retrospective, cross-sectional, diagnostic test accuracy study. Chest CT scans, carried out from May 1 to June 30, 2020, and from May 1 to July 17, 2017, were consecutively selected for the COVID-19 (positive reverse transcription-polymerase chain reaction [RT-PCR] for severe acute respiratory syndrome coronavirus 2 result) and control (pre-pandemic) groups, respectively. Four expert thoracic radiologists blindly interpreted each CT scan image. Sensitivity and specificity were calculated. ResultsA total of 160 chest CT scan images were included: 79 in the COVID-19 group (56 [43.5–67] years old, 41 men) and 81 in the control group (62 [52–72] years old, 44 men). Typically, an estimated specificity of 98.5% (95% confidence interval [CI] 98.1%–98.4%) was obtained. For the indeterminate classification as a diagnostic threshold, an estimated sensitivity of 88.3% (95% CI 84.7%–91.7%) and a specificity of 79.0% (95% CI 74.5%–83.4%), with an area under the curve of 0.865 (95% CI 0.838–0.895), were obtained. ConclusionThe RSNA classification system shows strong diagnostic accuracy for COVID-19 pneumonia, even against pre-pandemic controls. It can be an important aid in clinical decision-making, especially when a typical or indeterminate pattern is found, possibly advising retesting following an initial negative RT-PCR result and streamlining early management and isolation. ER -