THE CHEST RADIOGRAPH IN CYSTIC-FIBROSIS - A NEW SCORING SYSTEM COMPARED WITH THE CHRISPIN-NORMAN AND BRASFIELD SCORES

Background - Scoring systems for the chest radiograph in cystic fibros is are used to compare patients and different treatment regimens, and to monitor respiratory disease in individual patients. The Northern ch est radiograph score was designed to allow one person to assess the ra diological features of lung involvement in cystic fibrosis in as simpl e, rapid and equally reproducible manner as the established Chrispin a nd Norman, and Brasfield scoring systems. Methods - Forty five chest r adiographs were scored by 10 physicians with a special interest in cys tic fibrosis according to the Brasfield and Northern methods, and by f ive pairs of physicians according to the Chrispin-Norman criteria. Thr ee individuals and two pairs rescored the radiographs after an interva l of 3-5 months. The Northern score was performed with and without a l ateral view, using the original posteroanterior radiograph. Results - The Northern score showed a better agreement between observers for the ranking of the radiographs. It was equally well related to respirator y function tests, the Shwachman-Kulczycki score of overall clinical st atus, and in its discrimination between different radiographs as the o ther two scoring systems. The Northern score performed equally well wi th or without a lateral film. Conclusions - The Northern system fulfil s the requirements of a chest radiograph score more successfully than the Chrispin-Norman or Brasfield systems, and does not require a later al film.