A new radiographic scoring system for bronchopulmonary dysplasia. Newborn Lung Project.
OBJECTIVE
To develop a simple, clinically meaningful radiographic score for bronchopulmonary dysplasia (BPD). To investigate its reliability, validity, and usefulness and to compare it to the Edwards score.


OBJECTIVE
Our radiographic scoring of BPD is reliable, correlates with respiratory support, and provides a necessary standardization in comparing severity of respiratory disease between hospitals.


METHODS
Prospective cohort study.


METHODS
The study included all neonates (n = 366) with birth weight below 1501 g admitted to 7 neonatal intensive care units, who had chest radiographs taken at age 25-35 days.


METHODS
A simple radiographic scoring system was developed. Scores ranging from 0 to 6 were assigned based on standard radiographs and descriptors of degree of abnormality. All radiographs taken between days 25 and 35 of age (n = 1087) were graded by a radiologist and a neonatologist. Radiographs from a stratified random sample of 37 neonates (10%) were also scored by the method of Edwards (n = 128 radiographs). A respiratory support index was constructed for days 25-35 and correlated with the radiographic score.


RESULTS
Between-reader correlation was r = 0.87 for our score and r = 0.88 for the Edwards score. The two scores correlated with each other at r = 0.94. The respiratory support index correlated with our radiographic score at r = 0.75 overall, and r = 0.56 to 0.88 within hospitals. Higher postnatal corticosteroid use was found at the hospitals with the lower correlations.


CONCLUSIONS
Our radiographic scoring is reliable, valid, and gives results similar to the Edwards score. Radiographs play a standardizing role in assessing severity of BPD between hospitals.
Weinstein
M R
MR
Department of Neonatology, St. Mary's Hospital Medical Center, Madison, Wisconsin.
Peters
M E
ME
Sadek
M
M
Palta
M
M
D000367:Age Factors; D001997:Bronchopulmonary Dysplasia / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007484:Iowa; D008297:Male; D015588:Observer Variation; D010865:Pilot Projects; D011446:Prospective Studies; D011659:Pulmonary Gas Exchange / Q000502:physiology; D011859:Radiography; D012044:Regression Analysis; D015203:Reproducibility of Results; D015656:Respiratory Mechanics / Q000502:physiology; D012720:Severity of Illness Index; D014922:Wisconsin