Published in:
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.