RT Journal Article
SR Electronic
T1 Interobserver Agreement in the Interpretation of Outpatient Head CT Scans in an Academic Neuroradiology Practice
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
DO 10.3174/ajnr.A4058
A1 G. Guérin
A1 S. Jamali
A1 C.A. Soto
A1 F. Guilbert
A1 J. Raymond
YR 2014
UL http://www.ajnr.org/content/early/2014/07/24/ajnr.A4058.abstract
AB BACKGROUND AND PURPOSE: The repeatability of head CT interpretations may be studied in different contexts: in peer-review quality assurance interventions or in interobserver agreement studies. We assessed the agreement between double-blind reports of outpatient CT scans in a routine academic practice. MATERIALS AND METHODS: Outpatient head CT scans (119 patients) were randomly selected to be read twice in a blinded fashion by 8 neuroradiologists practicing in an academic institution during 1 year. Nonstandardized reports were analyzed to extract 4 items (answer to the clinical question, major findings, incidental findings, recommendations for further investigations) from each report, to identify agreement or discrepancies (classified as class 2 [mentioned or not mentioned or contradictions between reports], class 1 [mentioned in both reports but diverging in location or severity], 0 [concordant], or not applicable), according to a standardized data-extraction form. Agreement regarding the presence or absence of clinically significant or incidental findings was studied with κ statistics. RESULTS: The interobserver agreement regarding head CT studies with positive and negative results for clinically pertinent findings was 0.86 (0.77–0.95), but concordance was only 75.6% (67.2%–82.5%). Class 2 discrepancy was found in 15.1%; class 1 discrepancy, in 9.2% of cases. The κ value for reporting incidental findings was 0.59 (0.45–0.74), with class 2 discrepancy in 29.4% of cases. Most discrepancies did not impact the clinical management of patients. CONCLUSIONS: Discrepancies in double-blind interpretations of head CT examinations were more common than reported in peer-review quality assurance programs. Abbreviation CHUMCentre Hospitalier de l’Université de Montréal