Intraobserver and interobserver agreement of the interpretation of pediatric chest radiographs

Johnson, Jeremiah; Kline, Jeffrey A.

doi:10.1007/s10140-009-0854-2

Cited by 83 publications

(64 citation statements)

References 19 publications

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“…Of course, variability in interpretation can also be influenced by other factors than training or experience, such as radiographic quality, and individual radiologist variability (TUDOR; FINLAY; TAUB, 1997;HERMAN et al, 1975;KLINE, 2010). Even amongst experienced and trained radiologists, there is variation in interpretation and diagnostic performance, as we observed and as has been reported (BREALEY; SCALLY; THOMAS, 2002).…”

Section: Discussionsupporting

confidence: 70%

“…Therefore, it is possible that some discrepancies will be associated to simple human error related to cognitive bias (GUNDERMAN, 2009), different emotions or physical tiredness during the interpretation (TUDOR; FINLAY; TAUB, 1997;HERMAN et al, 1975;KLINE, 2010). This can happen to any observers independent of the degree of training and experience.…”

Section: Discussionmentioning

confidence: 99%

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Interobserver agreement in interpretation of radiographic pulmonary changes in dogs in relation to radiology training

Froes¹,

Zwingenberger

Sato

et al. 2014

Sem. Ci. Agr.

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Interpretation of pulmonary radiographs is one of the most difficult aspects of radiology and interobserver variability is high. The aim of this study was to assess variations in interpretation of pulmonary pathology amongst Brazilian veterinarians with different levels of training and experience, using the interpretation by American board-certified radiologists as a reference. We identified areas where interpretation is particularly challenging. Sixty digital canine thoracic radiographic examinations were interpreted by four groups of three Brazilian observers, each group being defined by different levels of training and experience. The radiographic findings of the 4 groups of observers in the study were compared to a reference interpretation established from the findings of three ACVR board-certified radiologists. The degree of discrepancy for each list between each group and the reference interpretation was assessed according to a three-level scoring system: no discrepancy, minor discrepancy, or major discrepancy. Data was analyzed using a Kappa and Cochran-Mantel-Haenszel tests. Brazilian veterinarians with the most training and experience showed the least interobserver variation and best performance when compared to the reference interpretation, followed by those with practical training, but with little work experience in professional practice. The radiographic patterns that were associated with the highest interobserver variability were the vascular, unstructured interstitial and bronchial patterns. Interobserver major discrepancies occurred in all groups, but is more evident in groups with the least training (44.4%) and the general practitioners (26.7%) group. It can be concluded that training positively influences the accuracy of radiographic interpretation and is recommended to reduce erroneous diagnoses. Key words: Training, interobserver agreement, thoracic radiographs, pulmonary patterns ResumoUma das maiores dificuldades na interpretação radiográfica em cães está nas alterações pulmonares sendo a variabilidade interobservador alta. O objetivo desse estudo é detectar as variações de interpretação entre radiologistas brasileiros em diferentes graus de treinamento e experiência, utilizando a interpretação de consenso feito por radiologistas americanos certificados pelo Colégio Americano de Radiologia Veterinária. Na tentativa de identificar os desafios e as particularidades dessa interpretação. Sessenta exames radiográficos digitais do tórax de cães foram interpretados por quatro grupos de observadores com diferentes graus de treinamento em leitura de exames radiográficos. O grau de discrepância entre as observadores foram comparados seguindo um escore com três subclassificações: sem discrepância, discrepância leve e maiores discrepâncias. Para análise dos dados os métodos estatísticos utilizados foram o Kappa e Cochran-Mantel-Haenszel. Os veterinários brasileiros com maior grau de treinamento e experiência foram o que apresentaram menores variações de interpretação quando comparado aos dados d...

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Interobserver agreement in interpretation of radiographic pulmonary changes in dogs in relation to radiology training

Froes¹,

Zwingenberger

Sato

et al. 2014

Sem. Ci. Agr.

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“…Few prior studies have assessed the reliability of chest radiograph findings in children. 3,5,12,14,15 We found a high degree of agreement among radiologists for radiologic findings consistent with bacterial pneumonia when standardized interpretation criteria were applied. In this study, we identified radiographic features of pneumonia, such as alveolar infiltrate and pleural effusion, that were consistently identified by different radiologists reviewing the same radiograph and by the same radiologist reviewing the same radiograph.…”

Section: Discussionmentioning

confidence: 73%

“…2,3,15,18 Many of these prior studies emphasized variation in detection of radiographic findings that would not typically alter clinical management. We observed high intra-rater, and inter-rater reliability among radiologists for the findings of alveolar infiltrate and pleural effusion.…”

Section: Discussionmentioning

confidence: 99%

Variability in the interpretation of chest radiographs for the diagnosis of pneumonia in children

Neuman

Lee

Bixby

et al. 2011

Journal of Hospital Medicine

125

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BACKGROUND:Although chest radiography is commonly used to establish the diagnosis of pneumonia in children, the reliability of radiographic findings among radiologists is not well described.OBJECTIVE:We sought to evaluate the inter‐rater and intra‐rater reliability of radiographic features commonly described by radiologists in childhood pneumonia.METHODS:Prospective case‐based study. One hundred and ten radiographs of children evaluated in a pediatric emergency department for suspicion of pneumonia were interpreted by six radiologists at two academic children's hospitals. Radiologists were blinded to the clinical history. Reliability of standardized radiographic features was evaluated using the kappa statistic.RESULTS:The radiographic finding of an alveolar infiltrate demonstrated substantial reliability among radiologists (κ = 0.69). The presence of ‘any infiltrate’ and pleural effusion demonstrated moderate reliability (κ = 0.47 and k=0.45, respectively). Other radiographic features were less reliable: air bronchograms (κ = 0.32), hilar adenopathy (κ = 0.21), and interstitial infiltrate (κ = 0.14). Similarly, the finding of alveolar infiltrate demonstrated substantial intra‐rater reliability upon review of ten duplicate radiographs, whereas interstitial infiltrate was less reliable.CONCLUSION:The radiographic finding of an alveolar infiltrate is very reliable among pediatric radiologists, whereas the finding of an interstitial infiltrate is less reliable. Journal of Hospital Medicine 2012; © 2011 Society of Hospital Medicine.

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“…Even between 54 and 57 days of gestation (Group II) there is a 30% estimated error rate in estimated fetal number. This is due to a combination of factors and may be compounded by human cognitive bias errors (GUNDERMAN, 2009), the mental or physical fatigue of the radiologist, and observer variability (JOHNSON; KLINE, 2010;TUDOR et al, 2007). These factors may be independent of the training and experience of the radiologist.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of abdominal radiography to determine fetus numbers in bitches at two gestational ages

et al. 2015

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Abdominal radiography is considered the most accurate technique for determining fetal numbers. Nevertheless, there is a disagreement in the literature concerning the optimal time to perform the examination to obtain the most accurate fetal count. The objective of this study was to compare the accuracy of fetal counting in bitches at two gestational stages, using digital radiographs, and to analyze the possible complicating factors. Fifty-eight abdominal radiographs of 38 bitches at two gestational stages were analyzed by two observers. The first stage (Group I) included bitches between 45 and 48 days of gestation, and the second (Group II) bitches between 54 and 57 days of gestation. The Kappa index of agreement for categorical data indicated agreement between observers. Agreement was lower for Group I than for Group II. The estimated value of Pearson's coefficient for Group I was positive but weak for correlation between observers 1 and 2 and the number of puppies born. There was significant correlation between counts and the number of puppies born in Group II. We conclude that radiographic examination is not an accurate method of determining fetal number between 45 and 48 days of gestation and that the optimal time to perform this examination is between 54 and 57 days of gestation, at which time the fetal skull is fully visible on radiographs. Key words: Dog, fetal count, pregnancy, radiographic examination Resumo A radiografia de abdome é considerada a técnica mais precisa para a contagem do número de fetos. No entanto, há discordância na literatura sobre o momento ideal para realizar o exame para obter a contagem fetal mais precisa. Os objetivos deste estudo foram comparar, em dois períodos de gestação, a precisão da contagem fetal em cadelas a partir de radiografias digitais e analisar os possíveis fatores complicadores. Foram realizadas 58 radiografias abdominais de 38 cadelas analisadas por dois observadores em duas fases da gestação. A primeira fase (Grupo I) incluiu cadelas entre 45 e 48 dias de gestação, e a segunda (Grupo II) cadelas entre 54 e 57 dias de gestação. O índice de concordância Kappa para dados categóricos indicaram concordância entre os observadores. Não obstante, o acordo entre os observadores foi menor no Grupo I do que no Grupo II. O valor estimado do coeficiente de Pearson para o Grupo I foi fraco e positivo para a correlação entre o observador 1 e 2 e o número de filhotes nascidos. No Grupo II, houve correlação significativa entre a contagem e o número de filhotes nascidos. Conclui-se que o exame radiográfico não é um método acurado para a determinação do número de fetos entre 45 e 48 dias de gestação e que o tempo ideal para realizar o exame é entre 54 e 57 dias de gestação, momento em que o crânio do feto é totalmente visível na radiografia. Palavras-chave: Contagem fetal, cão, exame radiográfico, gestação

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Intraobserver and interobserver agreement of the interpretation of pediatric chest radiographs

Cited by 83 publications

References 19 publications

Interobserver agreement in interpretation of radiographic pulmonary changes in dogs in relation to radiology training

Interobserver agreement in interpretation of radiographic pulmonary changes in dogs in relation to radiology training

Variability in the interpretation of chest radiographs for the diagnosis of pneumonia in children

Accuracy of abdominal radiography to determine fetus numbers in bitches at two gestational ages

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