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Published in: Pediatric Radiology 12/2007

01-12-2007 | Original Article

Observer variability assessing US scans of the preterm brain: the ELGAN study

Authors: Karl Kuban, Ira Adler, Elizabeth N. Allred, Daniel Batton, Steven Bezinque, Bradford W. Betz, Ellen Cavenagh, Sara Durfee, Kirsten Ecklund, Kate Feinstein, Lynn Ansley Fordham, Frederick Hampf, Joseph Junewick, Robert Lorenzo, Roy McCauley, Cindy Miller, Joanna Seibert, Barbara Specter, Jacqueline Wellman, Sjirk Westra, Alan Leviton

Published in: Pediatric Radiology | Issue 12/2007

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Abstract

Background

Neurosonography can assist clinicians and can provide researchers with documentation of brain lesions. Unfortunately, we know little about the reliability of sonographically derived diagnoses.

Objective

We sought to evaluate observer variability among experienced neurosonologists.

Materials and methods

We collected all protocol US scans of 1,450 infants born before the 28th postmenstrual week. Each set of scans was read by two independent sonologists for the presence of intraventricular hemorrhage (IVH) and moderate/severe ventriculomegaly, as well as hyperechoic and hypoechoic lesions in the cerebral white matter. Scans read discordantly for any of these four characteristics were sent to a tie-breaking third sonologist.

Results

Ventriculomegaly, hypoechoic lesions and IVH had similar rates of positive agreement (68–76%), negative agreement (92–97%), and kappa values (0.62 to 0.68). Hyperechoic lesions, however, had considerably lower values of positive agreement (48%), negative agreement (84%), and kappa (0.32). No sonologist identified all abnormalities more or less often than his/her peers. Approximately 40% of the time, the tie-breaking reader agreed with the reader who identified IVH, ventriculomegaly, or a hypoechoic lesion in the white matter. Only about 25% of the time did the third party agree with the reader who reported a white matter hyperechoic lesion.

Conclusion

Obtaining concordance seems to be an acceptable way to assure reasonably high-quality of images needed for clinical research.
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Metadata
Title
Observer variability assessing US scans of the preterm brain: the ELGAN study
Authors
Karl Kuban
Ira Adler
Elizabeth N. Allred
Daniel Batton
Steven Bezinque
Bradford W. Betz
Ellen Cavenagh
Sara Durfee
Kirsten Ecklund
Kate Feinstein
Lynn Ansley Fordham
Frederick Hampf
Joseph Junewick
Robert Lorenzo
Roy McCauley
Cindy Miller
Joanna Seibert
Barbara Specter
Jacqueline Wellman
Sjirk Westra
Alan Leviton
Publication date
01-12-2007
Publisher
Springer-Verlag
Published in
Pediatric Radiology / Issue 12/2007
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-007-0605-z

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