Radiologists' agreement when using a 10-point scale to report abdominal radiographic findings of necrotizing enterocolitis in neonates and infants
Radiologists' agreement when using a 10-point scale to report abdominal radiographic findings of necrotizing enterocolitis in neonates and infants
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DOI：
10.2214/ajr.07.3558
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发表时间：
2008-07-01
影响因子：
5
通讯作者：
Bisset, George, III
中科院分区：
文献类型：
--
作者：
Coursey, Courtney A.;Hollingsworth, Caroline L.;Bisset, George, III
目标。本研究的目的是评估放射科医生在使用异常发现10分制时的一致性，该分制旨在规范新生儿或疑似坏死性小肠结肠炎婴儿腹部x线片的报告。材料和方法。在本研究开始前，我们的机构设计了一个10分制的放射检查结果量表，并使用了大约18个月。经机构审查委员会批准后，随机选择88张腹部x线片（正位片和交叉桌侧片）进行审查，根据原始检查报告在整个量表中均匀分配检查。总研究人群中患者的平均年龄为24.9天（范围0-56天）；女孩61例（47.3%），男孩68例（52.7%）。四名拥有20年、13年、7年和5年经验的儿科放射科医生根据量表至少间隔4周对图像进行两次评分，该量表旨在描述新生儿和可能患有坏死性小肠结肠炎的婴儿疾病的确定性和严重程度。通过加权kappa统计来评估观察者之间和观察者内部的一致性。回顾手术和病理报告。平均观察者内加权kappa值为0.792 （SD, 0.025；范围，0.635-0.946）。平均观察者间加权kappa值为0.665 （SD为0.035，范围0.574 ~ 0.898）。当放射科医师使用10分制报告疑似坏死性小肠结肠炎的新生儿或婴儿腹部x线片异常发现时，发现大量观察者内部和观察者之间的一致。该量表作为一种潜在有用的临床工具值得进一步评估。
OBJECTIVE. The purpose of this study was to evaluate radiologists' agreement when using a 10-point scale of abnormal findings designed to standardize reporting of abdominal radiographs in neonates or infants with suspected necrotizing enterocolitis.MATERIALS AND METHODS. A 10-point scale of radiographic findings was devised at our institution and was in use for approximately 18 months before the initiation of this study. After institutional review board approval, 88 abdominal radiographs (anteroposterior and cross-table lateral) were randomly selected for review, allowing for an equal distribution of examinations throughout the scale according to the original examination report. The mean age of the patients in the total study population was 24.9 days (range, 0-56 days); 61 patients (47.3%) were girls and 68 (52.7%) were boys. Four pediatric radiologists having 20, 13, 7, and 5 years of experience scored images twice at least 4 weeks apart according to the scale, which was designed to characterize certainty and severity of disease in neonates and infants with possible necrotizing enterocolitis. Interobserver and intraobserver agreement was assessed by applying weighted kappa statistics. Operative and pathology reports were reviewed.RESULTS. The average intraobserver weighted kappa value was 0.792 (SD, 0.025; range, 0.635-0.946). The average interobserver weighted kappa value was 0.665 (SD, 0.035, range, 0.574-0.898).CONCLUSION. Substantial intraobserver and interobserver agreement was found when radiologists used a 10-point scale to report abnormal findings on abdominal radiographs in neonates or infants with suspected necrotizing enterocolitis. This scale warrants further evaluation as a potentially useful clinical tool.