Radiological Society of North America (RSNA) Expert Consensus Statement Related to Chest CT Findings in COVID-19 Versus CO-RADS: Comparison of Reporting System Performance Among Chest Radiologists and End-User Preference
Radiological Society of North America (RSNA) Expert Consensus Statement Related to Chest CT Findings in COVID-19 Versus CO-RADS: Comparison of Reporting System Performance Among Chest Radiologists and End-User Preference
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DOI：
10.1177/0846537120968919
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发表时间：
2021-11-01
期刊：
影响因子：
3.1
通讯作者：
Bilawich, Ana-Maria
中科院分区：
文献类型：
--
作者：
O' Neill, Siobhan B.;Byrne, Danielle;Bilawich, Ana-Maria
目的：RSNA专家共识声明和CO-RADS报告系统有助于放射科医生以标准化的方式描述接受COVID-19肺炎调查的患者的肺部成像结果，并提供与其他医疗保健提供者沟通的清晰度。我们的目的是比较诊断性能和内部/内部观察者之间的胸部放射科医生在解释RSNA和CO-RADS报告系统，并评估临床医生的偏好。研究方法：由3名胸部放射科医生对279名接受RT-PCR检测的疑似COVID-19患者的胸部CT扫描进行回顾性独立检查，并根据RSNA和CO-RADS报告系统进行解释。进行观察者间/观察者内分析。计算两种报告系统的诊断准确性。60名临床医生参与了一项调查，以评估最终用户对报告系统的偏好。结果如下：两个系统均显示出几乎完美的观察者间一致性（RSNA的Fleiss kappa 0.871，P < 0.0001; CO-RADS印象的Fleiss kappa 0.876，P < 0.0001）。使用相同类别的2个评分系统之间的观察者内一致性几乎完美（Fleiss kappa 0.90-0.92，P < 0.001）。阳性预测值较高，RSNA为0.798-0.818，CO-RADS为0.891-0.903。阴性预测值相似，RSNA为0.573-0.585，CO-RADS为0.573-0.58。两种系统的特异性不同，CO-RADS为68-73%，RSNA为52-58%，CO-RADS的特异性上级。在60名调查参与者中，对于提供的所有选项，大多数人更喜欢RSNA报告系统而不是CO-RADS（66.7-76.7%; P < 0.05）。结论：RSNA和CO-RADS报告系统具有一致性和可重复性，具有近乎完美的观察者间/观察者内一致性和出色的阳性预测值。最终用户更喜欢RSNA系统中的报告语言。
Purpose: The RSNA expert consensus statement and CO-RADS reporting system assist radiologists in describing lung imaging findings in a standardized manner in patients under investigation for COVID-19 pneumonia and provide clarity in communication with other healthcare providers. We aim to compare diagnostic performance and inter-/intra-observer among chest radiologists in the interpretation of RSNA and CO-RADS reporting systems and assess clinician preference. Methods: Chest CT scans of 279 patients with suspected COVID-19 who underwent RT-PCR testing were retrospectively and independently examined by 3 chest radiologists who assigned interpretation according to the RSNA and CO-RADS reporting systems. Inter-/intra-observer analysis was performed. Diagnostic accuracy of both reporting systems was calculated. 60 clinicians participated in a survey to assess end-user preference of the reporting systems. Results: Both systems demonstrated almost perfect inter-observer agreement (Fleiss kappa 0.871, P < 0.0001 for RSNA; 0.876, P < 0.0001 for CO-RADS impressions). Intra-observer agreement between the 2 scoring systems using the equivalent categories was almost perfect (Fleiss kappa 0.90-0.92, P < 0.001). Positive predictive values were high, 0.798-0.818 for RSNA and 0.891-0.903 CO-RADS. Negative predictive value were similar, 0.573-0.585 for RSNA and 0.573-0.58 for CO-RADS. Specificity differed between the 2 systems, 68-73% for CO-RADS and 52-58% for RSNA with superior specificity of CO-RADS. Of 60 survey participants, the majority preferred the RSNA reporting system rather than CO-RADS for all options provided (66.7-76.7%; P < 0.05). Conclusions: RSNA and CO-RADS reporting systems are consistent and reproducible with near perfect inter-/intra-observer agreement and excellent positive predictive value. End-users preferred the reporting language in the RSNA system.