title: A recommended method in order to interpret chest x-rays for diagnosing small size pneumothorax.
abstract: BACKGROUND
  Pneumothorax can be a both progressive and life threatening disorder. In this survey we evaluated the diagnostic accuracy of a recommended method for the interpretation of chest X-Rays (CXRs) compared to the common method in diagnosis of iatrogenic Pneumothorax in an emergency department.
  
  
  METHODS
  We conducted a study on 100 CXRs (31 with the diagnosis of small size pneumothorax and 69 normal) of patients who have undergone the upper central venous catheterization. CXRs were interpreted by 5 Emergency Specialists (ESs) and 5 general practitioners (GPs) separately using the conventional and recommended method. Recommended method included a 90 degree rotation against the side of chateterization in addition to using a yellow shield as the background color. Presence of pneumothorax on the CXR was confirmed by a radiologist.
  
  
  RESULTS
  64.5% of the CXRs with pneumothorax were correctly diagnosed by GPs and 87.7% by ESs with reutine method and 83.2% and 97.4% by recommended method, respectively (P.value<0.001). 96.8% out of all CXRs were correctly diagnosed by GPs and 99.4% by ESs by conventional method and 97.9% by GP and 99.7% by ES was correctly diagnosed using recommended method(P.value<0.001). None of the underlying variables including sex, age, underlying diseases, the side of intervention did not affect on the diagnostic accuracy in either groups (P.value>0.05).
  
  
  CONCLUSIONS
  A significant raise was obtained in the diagnostic accuracy of CXR using the recommended method. This study can be a preliminary study to conduct further investigations in order to enhance the diagnostic accuracy of CXRs.
authors.affiliation: Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, I. R. Iran ; Department of Emergency Medicine, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, I. R. Iran.
authors.forename: Mohammad-Reza
authors.initials: MR
authors.lastname: Ghane
authors.forename: Amin
authors.initials: A
authors.lastname: Saburi
authors.forename: Hamid-Reza
authors.initials: HR
authors.lastname: Javadzadeh
keywords: Central venous catheterization; chest x-ray; diagnostic accuracy; iatrogenic pneumothorax; interpretation