Statistical evaluation of reader variability in assessing the diagnostic performance of optical coherence tomography.
Statistical evaluation of reader variability in assessing the diagnostic performance of optical coherence tomography.
复制标题
DOI：
10.1117/1.jbo.25.11.116002
复制
发表时间：
2020-11
影响因子：
3.5
通讯作者：
Boppart SA
中科院分区：
文献类型：
--
作者：
Erickson-Bhatt SJ;Simpson DG;Boppart SA
重要性：光学相干断层扫描（OCT）被广泛用作包括各种类型的癌症在内的各种疾病的潜在诊断工具。然而，OCT在不同癌症中的灵敏度和特异性分析产生的结果从11%到100%不等。因此，需要对设盲阅片人研究进行更详细的统计分析。目的：对一项设盲研究的结果进行了广泛的统计分析，该研究涉及乳腺肿瘤边缘的OCT，以评估阅片师变异性对灵敏度和特异性的影响。方法：具有不同水平经验的5名阅片者阅读OCT图像，评估了使用术中OCT系统收集的50张乳腺肿瘤边缘OCT图像。使用R语言进行统计建模和分析，以分析阅片者的经验和变异性。结果如下：统计分析表明，阅片者先前对OCT图像的经验与阅片者评估与组织学一致的概率直接相关。此外，与具有OCT治疗其他（非癌症）疾病经验的阅片人相比，具有既往OCT治疗乳腺癌经验的阅片人的结果与组织学一致的概率更高。结论：本研究的结果证明了读片员培训和经验对敏感性和特异性评估的潜在影响。他们还展示了通过结合来自多个读取器的结果来提高诊断性能的更大潜力。这些初步研究结果为进一步研究提供了有价值的方向。
Significance: Optical coherence tomography (OCT) is widely used as a potential diagnostic tool for a variety of diseases including various types of cancer. However, sensitivity and specificity analyses of OCT in different cancers yield results varying from 11% to 100%. Hence, there is a need for more detailed statistical analysis of blinded reader studies. Aim: Extensive statistical analysis is performed on results from a blinded study involving OCT of breast tumor margins to assess the impact of reader variability on sensitivity and specificity. Approach: Five readers with varying levels of experience reading OCT images assessed 50 OCT images of breast tumor margins collected using an intraoperative OCT system. Statistical modeling and analysis was performed using the R language to analyze reader experience and variability. Results: Statistical analysis showed that the readers’ prior experience with OCT images was directly related to the probability of the readers’ assessment agreeing with histology. Additionally, results from readers with prior experience specific to OCT in breast cancer had a higher probability of agreement with histology compared to readers with experience with OCT in other (noncancer) diseases. Conclusions: The results from this study demonstrate the potential impact of reader training and experience in the assessment of sensitivity and specificity. They also demonstrate even greater potential improvement in diagnostic performance by combining results from multiple readers. These preliminary findings suggest valuable directions for further study.