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Journal articles on the topic 'Interobserver agreement study'

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Author: Grafiati
Published: 10 December 2022
Last updated: 29 January 2023

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1

Jørgensen, Tue Smith, Ylva Hellsten, Hans Gottlieb, and Stig Brorson. "Assessment of diabetic foot ulcers based on pictorial material: an interobserver study." Journal of Wound Care 29, no. 11 (November 2, 2020): 658–63. http://dx.doi.org/10.12968/jowc.2020.29.11.658.

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Objective: The frequent change in clinicians, and the emerging use of photographic documentation in wound management, could require a more diverse treatment of patients due to poor interobserver agreement. The aim of this study was to assess the interobserver agreement of a commonly used classification system for diabetic foot ulcers (DFUs), the Meggitt–Wagner classification, and to compare the agreement on classification with the agreement in treatment recommendations. Method: An interobserver study was conducted based on a questionnaire linked to 30 photographs of DFUs. Different groups of observers were tested to investigate whether there was a difference between professions or level of education: experienced orthopaedic wound care doctors (n=7); nurses specialised in wound care (n=8) and untrained nurses assigned to a diabetic wound care training course (n=23). Krippendorff's alpha was used to calculate interobserver agreement, and an agreement of >0.67 was defined as substantial. Results: The Krippendorff's alpha value for interobserver agreement on the Meggitt–Wagner classification was 0.52 for the doctors group, 0.67 for the specialised nurses and 0.61 for the untrained nurses. The corresponding values regarding agreement on recommendation of surgical revision of the wound were 0.35, 0.22 and 0.15, respectively. The choice of dressing type or antibiotic treatment had even lower interobserver agreement. Conclusions: The interobserver agreement on the Meggitt–Wagner classification was substantial in the specialised nurse group, but the evaluation and treatment of DFUs should not be exclusively based on pictorial materials.
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Pedersen, Malene Roland Vils, Peter Obel Otto, Chris Vagn-Hansen, Torben Sørensen, and Søren Rafael Rafaelsen. "Interobserver Reliability and the Sigmoid Takeoff—An Interobserver Study." Cancers 14, no. 11 (June 4, 2022): 2802. http://dx.doi.org/10.3390/cancers14112802.

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Background: Colorectal cancer is the second most common cancer worldwide. The sigmoid takeoff is the landmark where the colon sigmoid curves toward the sacrum viewed from sagittal magnetic resonance imaging (MRI). The purpose of this study was to assess interobserver variability in the assessment of the anal verge and anorectal junction in patients diagnosed with rectal cancer on magnetic resonance imaging (MRI). Materials and Methods: The rectal MRI examinations were performed using a 1.5- or 3.0-tesla unit using an anterior coil and a standard scan protocol. Two senior radiologists assessed MRI scans from patients under investigation for rectal cancer. The two observers assessed the anal verge and takeoff in cm independently. Difference in agreement between the observers were evaluated using intraclass correlation (ICC) and graphically by Bland–Altman plots. Results: The study population (n = 122) included 68 (55.7%) female and 54 (44.3%) male subjects. The overall median age was 69.5 years (range 39–95 years). There was perfect agreement between the two observers when defining rectal tumor above or below the takeoff landmark. The reliability of measuring the distance from the anal verge to the sigmoid takeoff was 0.712. Conclusion: Overall, the study found a moderate reliability in assessing the location of the sigmoid takeoff, with a low difference in the distance measuring, as well as a good consensus concerning the determination of tumors in relation to the sigmoid takeoff. Routine implementation of this information within the report seems reasonable.
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Geijer, M., G. Gadeholt Göthlin, and J. H. Göthlin. "Observer variation in computed tomography of the sacroiliac joints: a retrospective analysis of 1383 cases." Acta Radiologica 48, no. 6 (July 2007): 665–71. http://dx.doi.org/10.1080/02841850701342146.

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Background: Computed tomography (CT) for evaluation of sacroiliitis has a higher diagnostic accuracy than radiography. There is a high degree of interobserver variation in evaluating sacroiliitis on radiographs. Purpose: To evaluate interobserver variation in CT of the sacroiliac joints for evaluation of sacroiliitis in a large number of patients. Material and Methods: 1383 CT examinations of the sacroiliac joints were reviewed by two observers. The outcomes as originally reported and the findings from the reviews were classified as no sacroiliitis, equivocal, unilateral sacroiliitis, or bilateral sacroiliitis. The unweighted kappa statistic was used for assessment of observer agreement. Results: The interobserver agreement between the two reviewers was good (κ = 0.6724), with excellent agreement on cases of bilateral sacroiliitis and moderate agreement on cases of unilateral sacroiliitis. Excellent agreement was also reached in normal cases. Compared to the original reports, there were moderate interobserver agreements between both reviewers' findings and the original reports (κ = 0.4651 and κ = 0.4481, respectively). Conclusion: The interobserver variation for the diagnosis of sacroiliitis on CT between two reviewers in a study setting showed good agreement, with moderate agreement between each of the observers and the original clinical reports. CT is a reliable method for evaluating the sacroiliac joints for changes of sacroiliitis.
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Puente, José M., Juan L. Alcazar, Pilar Martinez-Ten, Carmina Bermejo, María T. Troncoso, and Juan A. García-Velasco. "Interobserver Agreement in the Study of 2D and 3D Sonographic Criteria for Adenomyosis." Journal of Endometriosis and Pelvic Pain Disorders 9, no. 3 (May 7, 2017): 211–15. http://dx.doi.org/10.5301/jeppd.5000295.

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Objective To study the degree of interobserver agreement for already known two-dimensional (2D) and three-dimensional (3D) sonography criteria of adenomyosis. Methods Fifty cases (25 adenomyosis cases, 25 non-adenomyosis cases) were studied by four expert observers and a less-experienced researcher. Each sonographic adenomyosis criterion was separately studied. Interobserver agreement was analysed by the kappa index with 95% confidence interval (CI). Results The degree of agreement about diagnosing adenomyosis was high or very high in all pair-wise comparisons (kappa values of 0.58–0–92). The agreement on identifying intra-myometrial cysts (kappa values of 0.46–0.79) and evaluating the junctional zone (JZ) by 3D-transvaginal ultrasound (3D-TVS) (kappa index of 0.46–0.88) was good. The agreements reached when evaluating the other criteria varied, but good agreement was generally reached. Conclusions Both the 2D-TVS and 3D-TVS criteria employed in diagnosing adenomyosis were reproducible parameters in adenomyosis diagnostics. The results were reproducible, even by a less experienced observer.
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Guarnizo, Angela, Thanh B. Nguyen, Rafael Glikstein, and Nader Zakhari. "Computed tomography assessment of anterior ethmoidal canal dehiscence: An interobserver agreement study and review of the literature." Neuroradiology Journal 33, no. 2 (March 2, 2020): 145–51. http://dx.doi.org/10.1177/1971400920908524.

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Purpose The anterior ethmoidal artery can be injured in functional endoscopic sinus surgery. The ability of computed tomography (CT) to identify dehiscence of the anterior ethmoidal canal (AEC) has not been widely evaluated. The aim of this study was to evaluate the interobserver agreement in the CT assessment of AEC dehiscence. Methods We conducted a retrospective review of consecutive CT scans of the paranasal sinuses (PNS) between January 1, 2012, and December 31, 2012. Two neuroradiologists separately assessed the presence of AEC dehiscence, the presence of PNS opacification, and the best CT plane to evaluate the AEC. Statistical analysis included descriptive analysis and interobserver agreement (kappa coefficient). Results The AEC was below the skull base in 199 (22.3%) cases. Dehiscence of the AEC was found in 13.2% for reader 1 and in 7.3% for reader 2. The interobserver agreement for identification of AEC dehiscence was only fair (κ = 0.246). The interobserver agreement for the AEC dehiscence in cases with opacification of ethmoidal air cells was substantial (κ = 0.754). Conclusion The suboptimal interobserver agreement could potentially limit the usefulness of CT scans for routine assessment of AEC dehiscence. In patients with PNS opacification, CT scans could still add valuable information regarding AEC dehiscence.
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Osmond, Allison, Hector Li-Chang, Richard Kirsch, Dimitrios Divaris, Vincent Falck, Dong Feng Liu, Celia Marginean, et al. "Interobserver variability in assessing dysplasia and architecture in colorectal adenomas: a multicentre Canadian study." Journal of Clinical Pathology 67, no. 9 (July 8, 2014): 781–86. http://dx.doi.org/10.1136/jclinpath-2014-202177.

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AimsFollowing the introduction of colorectal cancer screening programmes throughout Canada, it became necessary to standardise the diagnosis of colorectal adenomas. Canadian guidelines for standardised reporting of adenomas were developed in 2011. The aims of the present study were (a) to assess interobserver variability in the classification of dysplasia and architecture in adenomas and (b) to determine if interobserver variability could be improved by the adoption of criteria specified in the national guidelines.MethodsAn a priori power analysis was used to determine an adequate number of cases and participants. Twelve pathologists independently classified 40 whole-slide images of adenomas according to architecture and dysplasia grade. Following a wash-out period, participants were provided with the national guidelines and asked to reclassify the study set.ResultsAt baseline, there was moderate interobserver agreement for architecture (K=0.4700; 95% CI 0.4427 to 0.4972) and dysplasia grade (K=0.5680; 95% CI 0.5299 to 0.6062). Following distribution of the guidelines, there was improved interobserver agreement in assessing architecture (K=0.5403; 95% CI 0.5133 to 0.5674)). For dysplasia grade, overall interobserver agreement remained moderate but decreased significantly (K=0.4833; 95% CI 0.4452 to 0.5215). Half of the cases contained high-grade dysplasia (HGD). Two pathologists diagnosed HGD in ≥75% of cases.ConclusionsThe improvement in interobserver agreement in classifying adenoma architecture suggests that national guidelines can be useful in disseminating knowledge, however, the variability in the diagnosis of HGD, even following guideline review suggests the need for ongoing knowledge-transfer exercises.
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PILLAI, PB, GS SAIPRASAD, DR BASANNAR, and AG GOKARN. "STUDY ON INTEROBSERVER AGREEMENT IN A GOITRE PREVALENCE SURVEY." Medical Journal Armed Forces India 51, no. 2 (April 1995): 95–99. http://dx.doi.org/10.1016/s0377-1237(17)30937-1.

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8

Kumar, Padam, Richard A. Hillesheim, Jeffrey R. Sawyer, James H. Beaty, David D. Spence, William C. Warner Jr., Benjamin W. Sheffer, and Derek M. Kelly. "Pediatric Femoral Shaft Fracture Classification: An Intraobserver and Interobserver Reliability Study." Journal of the Pediatric Orthopaedic Society of North America 4, no. 2 (May 1, 2022): 1–9. http://dx.doi.org/10.55275/jposna-2022-0036.

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Purpose: Fracture stability is important in choosing the optimal treatment for pediatric femoral fractures, although there is no consensus for characterizing a fracture as “stable” or “unstable.” The authors sought to measure interobserver and intraobserver reliability in classifying femoral fracture stability and examined the relationship between fracture ratio and perceived fracture stability and morphology. Methods: Fracture ratios were calculated from anteroposterior and lateral radiographs from 65 children aged 5 to 12 years, who were treated for femoral shaft fractures at a level 1 pediatric trauma center. Deidentified radiographs were placed into a PowerPoint presentation in random order and were shown to six fellowship-trained pediatric orthopaedic surgeons at two time points, 4 months apart. Raters classified stability as “stable/unstable” and morphology as “spiral/oblique/transverse.” Cohen and Fleiss kappa (k) values were calculated to determine intraobserver and interobserver reliability. Generalized linear modeling was used to compare FR to rater fracture stability and morphology. Results: The mean k for fracture stability for all raters was 0.68 (strong intraobserver agreement). The k for fracture stability during Round 1 was 0.53 (67.7% interobserver agreement, moderate). The k for fracture stability during Round 2 was 0.68 (75.4% interobserver agreement, strong). The mean k for fracture morphology for all raters was 0.79 (strong intraobserver agreement). The k for fracture morphology during Round 1 was 0.38 (15.4% agreement, fair). The k for fracture morphology during Round 2 was 0.46 (24.6% agreement, moderate). The average anteroposterior ratio in stable fractures was 1.32 compared with 1.78 in unstable fractures (P < 0.001). The average lateral ratio in stable fractures was 1.34 compared with 2.10 in unstable fractures (P < 0.001). Average anteroposterior and lateral ratios were highest in spiral fractures and lowest in transverse fractures (P < 0.003). Conclusions: Raters demonstrated strong intraobserver and interobserver agreement in classifying radiographic femoral fracture stability. Anteroposterior and lateral fracture ratios were significantly higher in unstable fractures.
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Peixoto, Carla, Maite Castro, Isabel Carriles, Maria de Arriba, Victoria Lapresa, and Juan Luis Alcazar. "Diagnosing Septate Uterus Using Three-Dimensional Ultrasound Using Three Different Classifications: An Interobserver and Intraobserver Agreement Study." Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics 43, no. 12 (December 2021): 911–18. http://dx.doi.org/10.1055/s-0041-1740271.

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Abstract Objective Currently, there are up to three different classifications for diagnosing septate uterus. The interobserver agreement among them has been poorly assessed. Objective To assess the interobserver agreement of nonexpert sonographers for classifying septate uterus using the European Society of Human Reproduction and Embryology/European Society for Gynaecological Endoscopy (ESHRE/ESGE), American Society for Reproductive Medicine (ASRM), and Congenital Uterine Malformations by Experts (CUME) classifications. Methods A total of 50 three-dimensional (3D) volumes of a nonconsecutive series of women with suspected uterine malformation were used. Two nonexpert examiners evaluated a single 3D volume of the uterus of each woman, blinded to each other. The following measurements were performed: indentation depth, indentation angle, uterine fundal wall thickness, external fundal indentation, and indentation-to-wall-thickness (I:WT) ratio. Each observer had to assign a diagnosis in each case, according to the three classification systems (ESHRE/ESGE, ASRM, and CUME). The interobserver agreement regarding the ESHRE/ESGE, ASRM, and CUME classifications was assessed using the Cohen weighted kappa index (k). Agreement regarding the three classifications (ASRM versus ESHRE/ESGE, ASRM versus CUME, ESHRE/ESGE versus CUME) was also assessed. Results The interobserver agreement between the 2 nonexpert examiners was good for the ESHRE/ESGE (k = 0.74; 95% confidence interval [CI]: 0.55–0.92) and very good for the ASRM and CUME classification systems (k = 0.95; 95%CI: 0.86–1.00; and k = 0.91; 95%CI: 0.79–1.00, respectively). Agreement between the ESHRE/ESGE and ASRM classifications was moderate for both examiners. Agreement between the ESHRE/ESGE and CUME classifications was moderate for examiner 1 and good for examiner 2. Agreement between the ASRM and CUME classifications was good for both examiners. Conclusion The three classifications have good (ESHRE/ESGE) or very good (ASRM and CUME) interobserver agreement. Agreement between the ASRM and CUME classifications was higher than that for the ESHRE/ESGE and ASRM and ESHRE/ESGE and CUME classifications.
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Kearns, Kevin P., and Nina N. Simmons. "Interobserver Reliability and Perceptual Ratings." Journal of Speech, Language, and Hearing Research 31, no. 1 (March 1988): 131–36. http://dx.doi.org/10.1044/jshr.3101.131.

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The purpose of this study was to examine the reliability of ratings of perceptual characteristics for 10 ataxic dysarthric subjects. The influence of the occurrence of "deviant" speech parameters on the calculation of reliability coefficients was also explored. Results indicated that overall interobserver agreement levels for minimally trained judges compared favorably to reliability coefficients reported in previous studies. Furthermore, levels of overall agreement were above levels of agreement expected on the basis of chance alone. In contrast to overall interobserver agreement, much lower levels of interobserver agreement were obtained when "occurrence Reliability" coefficients were calculated for deviant dimensions alone. However, occurrence reliability coefficients surpassed the level of agreement expected on the basis of chance alone for all subjects. Based on the results of this investigation, recommendations are made for modifying standard practices for obtaining interobserver reliability for perceptual ratings of speech characteristics.
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Loft, Martina Kastrup, Malene Roland Vils Pedersen, Peter Grimm, Andreas Hoffmann Lauritzen, Claus Dam, and Søren Rafael Rafaelsen. "Intra- and Interobserver Variability of Shear Wave Elastography in Rectal Cancer." Cancers 14, no. 11 (May 26, 2022): 2633. http://dx.doi.org/10.3390/cancers14112633.

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Background: Endorectal ultrasound (ERUS) is an important tool when evaluating complex rectal adenomas and rectal cancer, and the accuracy is improved by adding elastography measurements. A high interobserver agreement is imperative in clinical practice. Therefore, the aim of this study was to evaluate interobserver agreement assessed on real-time images. Additionally, we investigated the intra- and interobserver agreement between experienced and inexperienced observers. Materials and methods: We prospectively included patients referred to an ERUS at the Department of Radiology with a complex rectal polyp or suspected rectal malignancy. Two operators independently scanned each patient in turn. Furthermore, four observers assessed previously obtained images using three different methods for placing the region of interest (ROI). Three months later, the four observers reassessed the images to assess intraobserver variability. Results: A total of 19 patients were included for live assessment. Agreement of tumor classification was substantial for T stage (kappa: 0.86) and fair for N stage (kappa: 0.73), with an absolute agreement for T and N stages of 84% and 89%, respectively. Agreement of SWE was good for Emean (ICC 0.94, 95% CI 0.86–0.98) and fair for Emax (ICC 0.85, 95% CI 0.66–0.94). Intra- and interobserver agreement between inexperienced and experienced observers showed good to excellent agreement with all ROI methods. Conclusion: Interobserver agreement is high in SWE when performed in a clinical setting. We found the best agreement using the mean value of several ROIs. Intra- and interobserver agreement was high regardless of operator experience.
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Lepe, Marcos, Claire M. Eklund, M. Ruhul Quddus, and Cherie Paquette. "Atypical Glandular Cells: Interobserver Variability according to Clinical Management." Acta Cytologica 62, no. 5-6 (2018): 397–404. http://dx.doi.org/10.1159/000489968.

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Objective: The 2014 Bethesda System diagnostic criteria for atypical glandular cells (AGC) aids in classification of atypical cells in cervical cytology. There is limited literature regarding reproducibility and interobserver variability in the application of the 2014 AGC criteria. Our aim is to assess the interobserver variability of AGC with a focus on how diagnostic categories link with guideline-driven management. Study Design: Three observers re-reviewed 51 previously diagnosed AGC Papanicolaou tests. The diagnoses were categorized as follows: (1) according to guideline-specified management, and (2) as glandular vs. squamous lesions. The κ statistic was used to evaluate interobserver agreement. Results: The interobserver variability per guideline management by weighted 2-observer κ ranged from 0.009 to 0.530, with half of the interobserver pairings meeting the threshold for at least fair-moderate agreement. For categorization as glandular, squamous, or both, unweighted κ yielded at best fair interobserver agreement (κ = 0.250) in 1 pairing, with low κ scores in the remainder of reviewer pairs (range 0.015–0.152). Conclusions: There is significant interobserver variability in the diagnosis of AGC. The AGC cases when divided by clinical management had fair-moderate interobserver agreement, suggesting that diagnostic variability likely has a real effect on patient care. This diagnostic uncertainty should be understood by cytologists and clinicians.
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Pedersen, Malene Roland Vils, Martina Kastrup Loft, Claus Dam, Lone Ærenlund Lohmann Rasmussen, and Signe Timm. "Diffusion-Weighted MRI in Patients with Testicular Tumors—Intra- and Interobserver Variability." Current Oncology 29, no. 2 (February 2, 2022): 837–47. http://dx.doi.org/10.3390/curroncol29020071.

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In general, magnetic resonance (MR) diffusion-weighted imaging (DWI) has shown potential in clinical settings. In testicles parenchyma, the DW imaging helps differentiate and characterize benign from malignant lesions. Placement and size of the region of interest (ROI) may affect the ADC value. Therefore, the aim of this study was to investigate the intra- and interobserver variability in testicular tumors when measuring ADC using various types of regions of interest (ROI). Two observers performed the ADC measurements in testicular lesions based on three ROI methods: (1) whole volume, (2) round, and (3) small sample groups. Intra- and interobserver variability was analyzed for all ROI methods using intraclass correlation coefficients (ICC) and bland-altman plots. The two observers performed the measurements twice, three months apart. A total of 26 malignant testicle tumors were included. Interobserver agreement was excellent in tumor length (ICC = 0.98) and tumor width (ICC = 0.98). In addition, intraobserver agreement was excellent in tumor length (ICC = 0.98) and tumor width (ICC = 0.99). The whole volume interobserver agreement in the first reading was excellent (ICC = 0.93). Round ADC had an excellent (ICC = 0.93) and fair (ICC = 0.58) interobserver agreement, in the first and second reading, respectively. Interobserver agreement in ADC small ROIs was good (ICC = 0.87), and good (ICC = 0.78), in the first and second reading, respectively. Intraobserver agreement varied from fair, good to excellent agreement. The ROI method showed varying inter- and intraobserver agreement in ADC measurement. Using multiple small ROI conceded the highest interobserver variability, and, thus, the whole volume or round seem to be the preferable methods.
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Allende, Daniela S., Rish K. Pai, Hao Xie, and Xiuli Liu. "Colorectal Serrated Polyp With Stromal Changes: An Interobserver Agreement Study." Gastroenterology Research 12, no. 6 (2019): 299–304. http://dx.doi.org/10.14740/gr1230.

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15

Pezzoli, A., R. Cannizzaro, M. Pennazio, E. Rondonotti, E. Bidoli, L. Zancanella, F. Cantoni, et al. "MULTICENTER STUDY OF INTEROBSERVER AGREEMENT IN DESCRIBING CAPSULE ENDOSCOPY FINDINGS." Digestive and Liver Disease 41 (March 2009): S46. http://dx.doi.org/10.1016/s1590-8658(09)60119-5.

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16

Robbins, P., S. Pinder, N. de Klerk, H. Dawkins, J. Harvey, G. Sterrett, I. Ellis, and C. Elston. "Histological grading of breast carcinomas: A study of interobserver agreement." Human Pathology 26, no. 8 (August 1995): 873–79. http://dx.doi.org/10.1016/0046-8177(95)90010-1.

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Pezzoli, Alessandro, Renato Cannizzaro, Marco Pennazio, Emanuele Rondonotti, Ettore Bidoli, Laura Zancanella, Franco Cantoni, et al. "Multicenter Study of Interobserver Agreement in Describing Capsule Endoscopy Findings." Gastrointestinal Endoscopy 69, no. 5 (April 2009): AB372. http://dx.doi.org/10.1016/j.gie.2009.03.1117.

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Bennett, Rebecca J., Dunay S. Taljaard, Michelle Olaithe, Chris Brennan-Jones, and Robert H. Eikelboom. "Evaluating Random Error in Clinician-Administered Surveys: Theoretical Considerations and Clinical Applications of Interobserver Reliability and Agreement." American Journal of Audiology 26, no. 3 (September 18, 2017): 191–201. http://dx.doi.org/10.1044/2017_aja-16-0100.

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PurposeThe purpose of this study is to raise awareness of interobserver concordance and the differences between interobserver reliability and agreement when evaluating the responsiveness of a clinician-administered survey and, specifically, to demonstrate the clinical implications of data types (nominal/categorical, ordinal, interval, or ratio) and statistical index selection (for example, Cohen's kappa, Krippendorff's alpha, or interclass correlation).MethodsIn this prospective cohort study, 3 clinical audiologists, who were masked to each other's scores, administered the Practical Hearing Aid Skills Test–Revised to 18 adult owners of hearing aids. Interobserver concordance was examined using a range of reliability and agreement statistical indices.ResultsThe importance of selecting statistical measures of concordance was demonstrated with a worked example, wherein the level of interobserver concordance achieved varied from “no agreement” to “almost perfect agreement” depending on data types and statistical index selected.ConclusionsThis study demonstrates that the methodology used to evaluate survey score concordance can influence the statistical results obtained and thus affect clinical interpretations.
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Nakamura, Sandra Akemi, Mário Müller Lorenzato, Edgard Eduard Engel, Maurício Eiji de Almeida Santos Yamashita, and Marcello Henrique Nogueira-Barbosa. "Incidental enchondromas at knee magnetic resonance imaging: intraobserver and interobserver agreement and prevalence of imaging findings." Radiologia Brasileira 46, no. 3 (June 2013): 129–33. http://dx.doi.org/10.1590/s0100-39842013000300004.

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Objective To evaluate intra- and interobserver agreement in the identification of incidental enchondromas at knee magnetic resonance imaging, and to assess the prevalence of imaging findings. Materials and Methods Retrospective study reviewing 326 knee magnetic resonance images acquired in the period between November 2009 and September 2010. The images were independently and blindly analyzed by two specialists in musculoskeletal radiology, with the objective of identifying incidental enchondromas, presence of foci with signal similar to bone marrow and foci of signal absence suggestive of calcifications within the enchondromas. Inter- and intraobserver agreements were analyzed. Results Eleven lesions compatible with enchondromas (3.3%) were identified. The interobserver agreement for the presence of enchondroma was high. Prevalence of foci of bone marrow signal inside the enchondromas was of 54.55%, and foci suggestive of calcification corresponded to 36.36%. The intraobserver agreement for foci of bone marrow signal in enchondromas was perfect, and interobserver agreement was high. Conclusion The prevalence of incidental enchondromas in the current study was compatible with data in the literature. Excellent agreement was observed in the identification of enchondromas and in the assessment of imaging findings. A higher prevalence of fat signal foci was observed as compared with signal absence suggestive of calcifications.
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Aronson, Daniël C., J. Marco Schnater, Chris R. Staalman, Gerrit J. Weverling, Jack Plaschkes, Giorgio Perilongo, Julia Brown, et al. "Predictive Value of the Pretreatment Extent of Disease System in Hepatoblastoma: Results From the International Society of Pediatric Oncology Liver Tumor Study Group SIOPEL-1 Study." Journal of Clinical Oncology 23, no. 6 (February 20, 2005): 1245–52. http://dx.doi.org/10.1200/jco.2005.07.145.

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Purpose Preoperative staging (pretreatment extent of disease [PRETEXT]) was developed for the first prospective liver tumor study by the International Society of Pediatric Oncology (SIOPEL-1 study; preoperative chemotherapy and delayed surgery). Study aims were to analyze the accuracy and interobserver agreement of PRETEXT and to compare the predictive impact of three currently used staging systems. Patients and Methods Hepatoblastoma (HB) patients younger than 16 years who underwent surgical resection (128 of 154 patients) were analyzed. The centrally reviewed preoperative staging was compared with postoperative pathology (accuracy) in 91 patients (81%), and the local center staging was compared with the central review (interobserver agreement) in 97 patients (86%), using the agreement beyond change method (weighted κ). The predictive values of the three staging systems were compared in 110 patients (97%) using survival curves and Cox proportional hazard ratio estimates. Results Preoperative PRETEXT staging compared with pathology was correct in 51%, overstaged in 37%, and understaged in 12% of patients (weighted κ = 0.44; 95% CI, 0.26 to 0.62). The weighted κ value of the interobserver agreement was 0.76 (95% CI, 0.64 to 0.88). The Children's Cancer Study Group/Pediatric Oncology Group–based staging system showed no predictive value for survival (P = .516), but the tumor-node-metastasis–based system and PRETEXT system showed good predictive values (P = .0021 and P = .0006, respectively). PRETEXT seemed to be superior in the statistical fit. Conclusion PRETEXT has moderate accuracy with a tendency to overstage patients, shows good interobserver agreement (reproducibility), shows superior predictive value for survival, offers the opportunity to monitor the effect of preoperative therapy, and can also be applied in patients who have not had operations. For comparability reasons, we recommend that all HB patients included in trials also be staged according to PRETEXT.
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Han, Jae Wook, Soon Young Cho, and Kui Dong Kang. "Correlation between Optic Nerve Parameters Obtained Using 3D Nonmydriatic Retinal Camera and Optical Coherence Tomography: Interobserver Agreement on the Disc Damage Likelihood Scale." Journal of Ophthalmology 2014 (2014): 1–9. http://dx.doi.org/10.1155/2014/931738.

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Purpose. To compare stereometric parameters obtained by three-dimensional (3D) optic disc photography and optical coherence tomography (OCT) and assess interobserver agreement on the disc damage likelihood scale (DDLS).Methods. This retrospective study included 190 eyes from 190 patients classified as normal, glaucoma suspect, or glaucomatous. Residents at different levels of training completed the DDLS for each patient before and after attending a training module. 3D optic disc photography and OCT were performed on each eye, and correlations between the DDLS and various parameters obtained by each device were calculated.Results. We found moderate agreement (weighted kappa value, 0.59 ± 0.03) between DDLS scores obtained by 3D optic disc photography and the glaucoma specialist. The weighted kappa values for agreement and interobserver concordance increased among residents after the training module. Interobserver concordance was the poorest at DDLS stages 5 and 6. The DDLS scored by the glaucoma specialist had the highest predictability value (0.941).Conclusions. The DDLS obtained by 3D optic disc photography is a useful diagnostic tool for glaucoma. A supervised teaching program increased trainee interobserver agreement on the DDLS. DDLS stages 5 and 6 showed the poorest interobserver agreement, suggesting that caution is required when recording these stages.
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Sigafoos, Jeff, Donna Couzens, and Stephanie Gunn. "Reliability of a conductive education rating scale for assessing children with multiple disabilities." Australian Educational and Developmental Psychologist 11, no. 2 (November 1994): 12–17. http://dx.doi.org/10.1017/s0816512200027012.

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ABSTRACTAdaptive behaviour scales represent an alternative to standardised intelligence tests for assessing children with multiple disabilities. The purpose of the present study was to evaluate the reliability of an adaptive behaviour scale used in Hungarian Conductive Education programs for children with neurological impairments. Forty-five children with multiple disabilities were assessed on two separate occasions by their teachers and physiotherapists. Scores were compared across raters (interobserver agreement) and across the two assessment occasions (test-retest reliability). Interobserver agreement averaged 55.5%, and the overall test-retest reliability was 75%. Suggestions for improving interobserver agreement and test-retest reliability are discussed.
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Bergsma, Minke, Miryam C. Obdeijn, Stein J. Janssen, Gregory I. Bain, Ruurd L. Jaarsma, and Job N. Doornberg. "Influence of training on dorsal tangential radiographic view to detect screw protrusion after anterior plating of the distal radius: a cadaveric study." Journal of Hand Surgery (European Volume) 45, no. 8 (February 10, 2020): 864–70. http://dx.doi.org/10.1177/1753193419898060.

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In this cadaveric study of anterior plating of the distal radius, we aimed to determine the interobserver agreement and diagnostic performance for detecting dorsally protruding screws using the dorsal tangential radiographic view before and after specific training. Without prior instruction, 13 observers interpreted the dorsal tangential view of cadaveric specimens, in which anterior radial plates were placed. After seeing a training video on the dorsal tangential view, they repeated the task. Though we found that accuracy and interobserver agreement was lower than described in some other clinical series, training led to statistically significant improvements of (1) the interobserver agreement on the decision to exchange screws, (2) the self-confidence of the surgeon in obtaining adequate views, and (3) the number of fluoroscopic images required to obtain these views. After training, the number of protruding screws missed was reduced by 36%, but 7% of dorsally protruding screws was still missed.
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Tummers, Philippe, Kees Gerestein, Jan Willem Mens, Hans Verstraelen, and Helena van Doorn. "Interobserver Variability of the International Federation of Gynecology and Obstetrics Staging in Cervical Cancer." International Journal of Gynecologic Cancer 23, no. 5 (June 2013): 890–94. http://dx.doi.org/10.1097/igc.0b013e318292da65.

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ObjectiveThe objective of this study was to assess the interobserver variability of pelvic examination under anesthesia (EUA) in cervical cancer.MethodsSubsequent patients undergoing a staging procedure under anesthesia for primary cervical cancer were enrolled in the study. All clinicians assessed “blinded” tumor size, and the involvement of vagina, parametria, sacrouterine ligaments, pelvic sidewalls, bladder, and/or rectum. Items were scored varying from 1 (“certainly no involvement”), 2 (“not sure about involvement”), to 3 (”involvement”). Each individual decided on the International Federation of Gynecology and Obstetrics (FIGO) stage; also, the urge for imaging and treatment proposal were accounted for. Final FIGO staging was obtained by consensus of the team. Investigators were classified as experienced after more than 50 EUAs. All others were classified less experienced. The free-marginal κ values between experienced and less experienced investigators were calculated for all previously mentioned items.ResultsBetween February 2009 and December 2010, a total of 86 patients were enrolled. Among experienced investigators, a moderate interobserver agreement was found with regard to FIGO stage (free-marginal κ value of 0.49) and an excellent interobserver agreement on their proposed therapy (free-marginal κ value of 0.84). A lower level of agreement was found when comparing experienced with less experienced investigators: only a slight level of agreement on FIGO stage and a substantial agreement on their therapy proposal (free-marginal κ values of 0.03 and 0.66).ConclusionsWe describe only a moderate interobserver agreement on clinical staging of patients with cervical cancer. The interobserver agreement increases in the group of experienced doctors, indicating that EUA can be learned.
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de Groot, Marcel G., Marjorie de Neef, Marieke H. Otten, Job B. M. van Woensel, and Reinout A. Bem. "Interobserver Agreement on Clinical Judgment of Work of Breathing in Spontaneously Breathing Children in the Pediatric Intensive Care Unit." Journal of Pediatric Intensive Care 09, no. 01 (October 7, 2019): 034–39. http://dx.doi.org/10.1055/s-0039-1697679.

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AbstractClinical assessment of the work of breathing (WOB) remains a cornerstone in respiratory support decision-making in the pediatric intensive care unit (PICU). In this study, we determined the interobserver agreement of 30 observers (PICU physicians and nurses) on WOB and multiple signs of effort of breathing in 10 spontaneously breathing children admitted to the PICU. By reliability analysis, the agreement on overall WOB was poor to moderate, and only three separate signs of effort of breathing (breathing rate, stridor, and grunting) showed moderate-to-good interobserver reliability. We conclude that the interobserver agreement on the clinical WOB judgment among PICU physicians and nurses is low.
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Belloti, João Carlos, Marcel Jun Sugawara Tamaoki, Carlos Eduardo da Silveira Franciozi, João Baptista Gomes dos Santos, Daniel Balbachevsky, Eduardo Chap Chap, Walter Manna Albertoni, and Flávio Faloppa. "Are distal radius fracture classifications reproducible? Intra and interobserver agreement." Sao Paulo Medical Journal 126, no. 3 (May 2008): 180–85. http://dx.doi.org/10.1590/s1516-31802008000300008.

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CONTEXT AND OBJECTIVE: Various classification systems have been proposed for fractures of the distal radius, but the reliability of these classifications is seldom addressed. For a fracture classification to be useful, it must provide prognostic significance, interobserver reliability and intraobserver reproducibility. The aim here was to evaluate the intraobserver and interobserver agreement of distal radius fracture classifications. DESIGN AND SETTING: This was a validation study on interobserver and intraobserver reliability. It was developed in the Department of Orthopedics and Traumatology, Universidade Federal de São Paulo - Escola Paulista de Medicina. METHOD: X-rays from 98 cases of displaced distal radius fracture were evaluated by five observers: one third-year orthopedic resident (R3), one sixth-year undergraduate medical student (UG6), one radiologist physician (XRP), one orthopedic trauma specialist (OT) and one orthopedic hand surgery specialist (OHS). The radiographs were classified on three different occasions (times T1, T2 and T3) using the Universal (Cooney), Arbeitsgemeinschaft für Osteosynthesefragen/Association for the Study of Internal Fixation (AO/ASIF), Frykman and Fernández classifications. The kappa coefficient (κ) was applied to assess the degree of agreement. RESULTS: Among the three occasions, the highest mean intraobserver k was observed in the Universal classification (0.61), followed by Fernández (0.59), Frykman (0.55) and AO/ASIF (0.49). The interobserver agreement was unsatisfactory in all classifications. The Fernández classification showed the best agreement (0.44) and the worst was the Frykman classification (0.26). CONCLUSION: The low agreement levels observed in this study suggest that there is still no classification method with high reproducibility.
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Mansur, Henrique, Lucas Sacramento Ramos, and Anderson Freitas. "TL 18167 - Reproducibility assessment of the Lauge-Hansen, Danis-Weber and AO classifications of ankle fractures." Scientific Journal of the Foot & Ankle 13, Supl 1 (November 11, 2019): 98S. http://dx.doi.org/10.30795/scijfootankle.2019.v13.1093.

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Introduction: Although there are some studies on the reproducibility of various classifications of ankle fractures, they are controversial and lack consensus on which classification is the most appropriate. Thus, the objective of this study is to identify which of the 3 main ankle fracture classifications has the highest intra- and interobserver reproducibility and to assess whether the medical training stage of the participants affects the evaluation. Methods: Radiographs of 30 patients with ankle fracture in anteroposterior (AP), profile and true AP views were selected. All images were evaluated by 11 participants at different stages of their medical training (5 residents and 6 orthopedic surgeons) and at 2 different times. Intra- and interobserver agreement was analyzed using the weighted Cohen's kappa coefficient. Paired Student's t-tests were performed to assess whether the degree of interobserver agreement significantly differed between classification methods. Results: The results showed significant agreement in all classifications when analyzing intraobserver agreement alone. The Danis-Weber classification showed a highly significant (p<0.0001) moderate-to-excellent interobserver agreement. The Danis-Weber classification had, on average, a significantly higher degree of agreement than the other classification methods (p<0.0001). Conclusion: The Danis-Weber classification had the highest reproducibility among the classification methods evaluated in this study.
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Bemelman, Michael, Mark van Baal, Claudia Raaijmakers, Koen Lansink, Luke Leenen, and William Long. "An Interobserver Agreement Study with a New Classification for Rib Fractures." Chirurgia 114, no. 3 (2019): 352. http://dx.doi.org/10.21614/chirurgia.114.3.352.

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Almalki, Mansour J., Mohammed A. Fatani, Dhafer M. Alahmari, Fayka K. Abdel Azeem, Ali M. Alqarni, Abdullah Alqarni, and Mohammed J. Alsaadi. "Detection and diagnosis of posterior circulation calcification: An interobserver agreement study." European Journal of Radiology Open 10 (2023): 100461. http://dx.doi.org/10.1016/j.ejro.2022.100461.

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Arana, Estanislao, Francisco M. Kovacs, Ana Royuela, Beatriz Asenjo, Fatima Nagib, Sandra Pérez-Aguilera, María Dejoz, et al. "Metastatic Versus Osteoporotic Vertebral Fractures on MRI: A Blinded, Multicenter, and Multispecialty Observer Agreement Evaluation." Journal of the National Comprehensive Cancer Network 18, no. 3 (March 2020): 267–73. http://dx.doi.org/10.6004/jnccn.2019.7367.

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Background: MRI is assumed to be valid for distinguishing metastatic vertebral fractures (MVFs) from osteoporotic vertebral fractures (OVFs). This study assessed (1) concordance between the image-based diagnosis of MVF versus OVF and the reference (biopsy or follow-up of >6 months), (2) interobserver and intraobserver agreement on key imaging findings and the diagnosis of MVF versus OVF, and (3) whether disclosing a patient’s history of cancer leads to variations in diagnosis, concordance, or agreement. Patients and Methods: This retrospective cohort study included clinical data and imaging from 203 patients with confirmed MVF or OVF provided to 25 clinicians (neurosurgeons, radiologists, orthopedic surgeons, and radiation oncologists). From January 2018 through October 2018, the clinicians interpreted images in conditions as close as possible to routine practice. Each specialist assessed data twice, with a minimum 6-week interval, blinded to assessments made by other clinicians and to their own previous assessments. The kappa statistic was used to assess interobserver and intraobserver agreement on key imaging findings, diagnosis (MVF vs OVF), and concordance with the reference. Subgroup analyses were based on clinicians’ specialty, years of experience, and complexity of the hospital where they worked. Results: For diagnosis of MVF versus OVF, interobserver agreement was fair, whereas intraobserver agreement was substantial. Only the latter improved to almost perfect when a patient’s history of cancer was disclosed. Interobserver agreement for key imaging findings was fair or moderate, whereas intraobserver agreement on key imaging findings was moderate or substantial. Concordance between the diagnosis of MVF versus OVF and the reference was moderate. Results were similar regardless of clinicians’ specialty, experience, and hospital category. Conclusions: When MRI is used to distinguish MVF versus OVF, interobserver agreement and concordance with the reference were moderate. These results cast doubt on the reliability of basing such a diagnosis on MRI in routine practice.
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Zabotti, Alen, Georgios Filippou, Marco Canzoni, Antonella Adinolfi, Valentina Picerno, Greta Carrara, Peter Balint, et al. "OMERACT agreement and reliability study of ultrasonographic elementary lesions in osteoarthritis of the foot." RMD Open 5, no. 1 (March 2019): e000795. http://dx.doi.org/10.1136/rmdopen-2018-000795.

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ObjectiveTo evaluate the level of agreement on ultrasonographic (US) lesions among highly experienced sonographers as well as the intraobserver and interobserver reliability of inflammatory and structural US lesions in patients with osteoarthritis (OA) of the foot.MethodsAfter a systematic literature review, a Delphi survey was performed to test definitions of US lesions in OA of the foot, including inflammatory lesions (ie, synovial hypertrophy [SH], joint effusion [JE], power Doppler signal [PD]), and structural abnormalities (ie, cartilage damage [CD] and osteophytes). Subsequently, the reliability of US in assessing the aforementioned lesions was tested on static images as well as during a live exercise. Reliability was assessed by kappa analyses and prevalence-adjusted bias-adjusted kappa (PABAK) on a dichotomous and an ordinal scale.ResultsIntraobserver and interobserver reliability for SH and JE evaluated by binary scoring was good for both components, while the intraobserver reliability for semiquantitative scoring of SH ranged from moderate in the web-based exercise (PABAK 0.49) to good (PABAK 0.8) in the live exercise. Reliability for CD and PD assessments were respectively good and excellent in all exercises (ranged from PABAK 0.61 to 0.79 for CD and 0.88 to 0.95 for PD). The interobserver reliability for the semiquantitative scoring of osteophytes was fair in the live exercise (PABAK 0.36) and moderate in the static exercise (PABAK 0.60).ConclusionsConsensual US definitions were found to be reliable for assessing inflammatory lesions in OA of the foot, while the use of US to assess structural damage requires further studies.
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Abdel Razek, Ahmed Abdel Khalek, Lamiaa El-Serougy, Amani Ezzat, Hany Eldawoody, and Ahmad El-Morsy. "Interobserver Agreement of White Matter Tract Involvement in Gliomas with Diffusion Tensor Tractography." Journal of Neurological Surgery Part A: Central European Neurosurgery 81, no. 03 (November 27, 2019): 233–37. http://dx.doi.org/10.1055/s-0039-1700560.

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Abstract Aim To assess with diffusion tensor tractography (DTT) the interobserver agreement of white matter tract involvement in patients with gliomas. Patient and Methods A prospective study was conducted on 35 patients (21 male, 14 female; age: 2–71 years) with gliomas that underwent DTT. Two independent readers assessed the patterns of involvement of the corticospinal tract, corpus callosum, optic radiation, and fasciculi as normal, edematous, displaced, infiltrated, or disrupted. Results Overall interobserver agreement of involvement of the white matter tracts was excellent (κ = 0.93; 95% confidence interval [CI], 0.91–0.95; p = 0.001). Interobserver agreement was excellent for involvement of corticospinal tracts (κ = 0.81; 95% CI, 0.57–1.00; p = 0.001), corpus callosum (κ = 0.91; 95% CI, 0.75–1.00; p = 0.001), optic radiation (κ = 0.77; 95% CI, 0.53–0.98; p = 0.001), and fasciculi (κ = 0.912; 95% CI, 0.81–0.99; p = 0.001. The interobserver agreement was excellent for tract edema (κ = 0.81; 95% CI, 0.57–1.00; p = 0.001), tract displacement (κ = 0.91; 95% CI, 0.75–1.00; p = 0.001), tract disruption (κ = 0.81; 95% CI, 0.57–1.00; p = 0.001), and good for tract infiltration (κ = 0.77; 95% CI, 0.53–0.98; p = 0.001). The interobserver agreement was excellent for white matter tract involvement in patients with low-grade gliomas (κ = 0.81; 95% CI, 0.57–1.00; p = 0.001) and high-grade gliomas (κ = 0.91; 95% CI, 0.75–1.00; p = 0.001). Conclusion DTT is a reliable and reproducible method for assessment of white matter tract involvement in patients with low- and high-grade gliomas.
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Wasques, Danilo, Juliana Guerra, Natália Fernandes, Maíra Martins, Emerson Mota, and Bruno Cogliati. "Interobserver variability in the diagnosis of canine hepatoid gland tumors." Brazilian Journal of Veterinary Pathology 15, no. 2 (July 31, 2022): 73–82. http://dx.doi.org/10.24070/bjvp.1983-0246.v15i2p73-82.

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The reported prevalence of canine hepatoid gland tumor (HGT) varies widelyowing mainly to the lack of well-defined diagnostic criteria and poor interobserver agreement. The aim of the present study was to improve the level of diagnostic agreement among pathologists in canine HGT. Five pathologists diagnosed and classified morphological features in 57 cases of canine HGT and, based on their reports, diagnostic algorithms were devised using recursive partitioning analysis. The proportion of diagnoses of malignant hepatoid neoplasia among the five pathologists ranged from 26.3 to 50.9%. Interobserver diagnostic agreement was classified as fair (κ=0.54) but improved to good (κ~0.65) following application of two novel diagnostic algorithms based on histomorphological features as sebaceous differentiation, mitotic count, atypical mitosis and cellular atypia. This study has demonstrated that interobserver agreement in the diagnosis of canine HGT could be improved using novel algorithms. Further analyses are warranted to validate the proposed classification systems applying a higher sampling of canine HGTs.
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Netto, George J., David L. Watkins, James W. Williams, Thomas V. Colby, Giovanni dePetris, Francis E. Sharkey, Christopher L. Corless, et al. "Interobserver Agreement in Hepatitis C Grading and Staging and in the Banff Grading Schema for Acute Cellular Rejection: The “Hepatitis C 3” Multi-Institutional Trial Experience." Archives of Pathology & Laboratory Medicine 130, no. 8 (August 1, 2006): 1157–62. http://dx.doi.org/10.5858/2006-130-1157-iaihcg.

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Abstract Context.—Establishing adequate interobserver agreement is crucial not only for standardization of patient care but also to ensure validity of findings in multi-institutional trials. Objective.—To evaluate interobserver agreement in assessing chronic hepatitis C (HCV) and acute cellular rejection (ACR) among 17 hepatopathologists involved in the “Hepatitis C 3” trial. Design.—The trial is a randomized multicenter (17 institutions) study involving 312 patients undergoing transplantation for HCV. Patients are randomized to 3 treatment arms. For final data analysis, all biopsy specimens are reviewed by a central pathologist (G.J.N.). Recurrence of HCV is evaluated according to the Batts and Ludwig schema. The 1997 Banff schema is used to evaluate ACR. To assess interobserver agreement, hematoxylin-eosin–stained sections from 11 liver biopsy specimens (6 HCV and 5 ACR) were sent by the central pathologist to 16 local pathologists from 13 institutions. Statistical analysis was performed on raw ACR/HCV data as well as data grouped according to clinically significant primary endpoint cutoffs. Results.—Statistically significant agreement was found among all participating pathologists (P &lt; .001). On κ analysis, the degree of agreement was rated “moderate” for HCV grade and stage and ACR global grading (κ = 0.30, 0.33, and 0.37, respectively). Interobserver agreement was weaker for rejection activity index scoring of ACR (κ = 0.15). A stronger degree of agreement was found when scores were grouped based on endpoint cutoffs (κ = 0.76 “almost perfect” for HCV and 0.62 “substantial” for ACR). Conclusions.—An overall statistically significant interobserver agreement was found among 17 pathologists using the 1997 Banff schema and the Batts and Ludwig schema.
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Kawaguchi, Yurika Maria Fogaça, Ricardo Kenji Nawa, Thais Borgheti Figueiredo, Lourdes Martins, and Ruy Camargo Pires-Neto. "Perme Intensive Care Unit Mobility Score and ICU Mobility Scale: translation into Portuguese and cross-cultural adaptation for use in Brazil." Jornal Brasileiro de Pneumologia 42, no. 6 (December 2016): 429–34. http://dx.doi.org/10.1590/s1806-37562015000000301.

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ABSTRACT Objective: To translate the Perme Intensive Care Unit Mobility Score and the ICU Mobility Scale (IMS) into Portuguese, creating versions that are cross-culturally adapted for use in Brazil, and to determine the interobserver agreement and reliability for both versions. Methods: The processes of translation and cross-cultural validation consisted in the following: preparation, translation, reconciliation, synthesis, back-translation, review, approval, and pre-test. The Portuguese-language versions of both instruments were then used by two researchers to evaluate critically ill ICU patients. Weighted kappa statistics and Bland-Altman plots were used in order to verify interobserver agreement for the two instruments. In each of the domains of the instruments, interobserver reliability was evaluated with Cronbach's alpha coefficient. The correlation between the instruments was assessed by Spearman's correlation test. Results: The study sample comprised 103 patients-56 (54%) of whom were male-with a mean age of 52 ± 18 years. The main reason for ICU admission (in 44%) was respiratory failure. Both instruments showed excellent interobserver agreement ( > 0.90) and reliability ( > 0.90) in all domains. Interobserver bias was low for the IMS and the Perme Score (−0.048 ± 0.350 and −0.06 ± 0.73, respectively). The 95% CIs for the same instruments ranged from −0.73 to 0.64 and −1.50 to 1.36, respectively. There was also a strong positive correlation between the two instruments (r = 0.941; p < 0.001). Conclusions: In their versions adapted for use in Brazil, both instruments showed high interobserver agreement and reliability.
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Al-Tameemi, Haider Najim, Sattar Al-Essawi, Mahmud Shukri, and Farah Kasim Naji. "Using Magnetic Resonance Myelography to Improve Interobserver Agreement in the Evaluation of Lumbar Spinal Canal Stenosis and Root Compression." Asian Spine Journal 11, no. 2 (April 30, 2017): 198–203. http://dx.doi.org/10.4184/asj.2017.11.2.198.

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<sec><title>Study Design</title><p>Cross-sectional retrospective study designed to assess interobserver agreement.</p></sec><sec><title>Purpose</title><p>To investigate if interobserver agreement using magnetic resonance imaging (MRI) in the evaluation of lumbar spinal canal stenosis and root compression can be improved upon combination with magnetic resonance myelography (MRM).</p></sec><sec><title>Overview of Literature</title><p>The interpretation of lumbar spinal MRI, which is the imaging modality of choice, often has a significant influence on the diagnosis and treatment of low back pain. However, using MRI alone, substantial interobserver variability has been reported in the evaluation of lumbar spinal canal stenosis and nerve root compression.</p></sec><sec><title>Methods</title><p>Hardcopies of 30 lumbar spinal MRI (containing a total of 150 disk levels) as well as MRM films were separately reviewed by two radiologists and a neurosurgeon. At each intervertebral disk, the observers were asked to evaluate the thecal sac for the presence and degree of spinal stenoses (mild, moderate, or severe) and presence of root canal compression. Interobserver agreement was measured using weighted kappa statistics.</p></sec><sec><title>Results</title><p>Regarding lumbar spinal canal stenosis, interobserver agreement between the two radiologists was moderate (kappa, 0.4) for MRI and good (kappa, 0.6) for combination with MRM. However, the agreement between the radiologist and neurosurgeon remained fair for MRI alone or in combination with MRM (kappa, 0.38 and 033, respectively). In the evaluation of nerve root compression, interobserver agreement between the radiologists improved from moderate (kappa, 0.57) for MRI to good (kappa, 0.73) after combination with MRM; moderate agreement between the radiologist and neurosurgeon was noted for both MRI alone and after combination with MRM (kappa, 0.58 and 0.56, respectively).</p></sec><sec><title>Conclusions</title><p>Interobserver agreement in the evaluation of lumbar spinal canal stenosis and root compression between the radiologists improved when MRM was combined with MRI, relative to MRI alone.</p></sec>
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Silva, Alexandre Tejo Pereira de Brito, Lucas Tejo Pereira de Brito Silva, Alysson Emannuel Neves Rodrigues Vieira, Cibelle Ingrid Estevão de Melo, José Jailson Costa do Nascimento, Carlos Fernando de Mello Júnior, Selene Cordeiro Vasconcelos, and Severino Aires de Araújo-Neto. "Craniometric parameters for the evaluation of platybasia and basilar invagination on magnetic resonance imaging: a reproducibility study." Radiologia Brasileira 53, no. 5 (October 2020): 314–19. http://dx.doi.org/10.1590/0100-3984.2019.0068.

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Abstract Objective: The present study aims to perform a reproducibility study of the clivus-canal angle (CCA), Welcker’s basal angle (WBA), and the distance from the odontoid process to Chamberlain’s line (DOCL) on magnetic resonance imaging (MRI). Materials and Methods: Two medical students and two radiologists respectively evaluated 100 and 50 consecutive MRI scans of adult skulls, selected randomly. Each examiner, working independently and blinded to the previous results, performed readings for each patient on two different occasions. Measurements were performed in T1-weighted sequences acquired in the midsagittal plane. The levels of intraobserver reproducibility and interobserver agreement were evaluated by calculating the intraclass correlation coefficients (ICCs) and the corresponding 95% confidence intervals. Results: The mean values obtained by the examiners were 150° for the CCA, 130° for the WBA, and 2.5 mm for the DOCL. The ICC for interobserver agreement was 0.980, 0.935, and 0.967, for the CCA, WBA, and DOCL, respectively, for the students, compared with 0.977, 0.941, and 0.982, respectively, for the radiologists, and 0.980, 0.992, and 0.990, respectively, for all of the examiners together. In the analysis of intraobserver agreement, the ICC ranged from 0.929 to 0.959 for the CCA, from 0.918 to 0.964 for the WBA, and from 0.918 to 0.981 for the DOCL. Conclusion: The measurement of the CCA, WBA, and DOCL appears to show excellent intraobserver reproducibility and interobserver agreement on MRI.
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Barra, Filipe Ramos, Fernanda Freire de Souza, Rosimara Eva Ferreira Almeida Camelo, Andrea Campos de Oliveira Ribeiro, and Luciano Farage. "Accuracy of contrast-enhanced spectral mammography for estimating residual tumor size after neoadjuvant chemotherapy in patients with breast cancer: a feasibility study." Radiologia Brasileira 50, no. 4 (August 2017): 224–30. http://dx.doi.org/10.1590/0100-3984.2016-0029.

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Abstract Objective: To assess the feasibility of contrast-enhanced spectral mammography (CESM) of the breast for assessing the size of residual tumors after neoadjuvant chemotherapy (NAC). Materials and methods: In breast cancer patients who underwent NAC between 2011 and 2013, we evaluated residual tumor measurements obtained with CESM and full-field digital mammography (FFDM). We determined the concordance between the methods, as well as their level of agreement with the pathology. Three radiologists analyzed eight CESM and FFDM measurements separately, considering the size of the residual tumor at its largest diameter and correlating it with that determined in the pathological analysis. Interobserver agreement was also evaluated. Results: The sensitivity, specificity, positive predictive value, and negative predictive value were higher for CESM than for FFDM (83.33%, 100%, 100%, and 66% vs. 50%, 50%, 50%, and 25%, respectively). The CESM measurements showed a strong, consistent correlation with the pathological findings (correlation coefficient = 0.76-0.92; intraclass correlation coefficient = 0.692-0.886). The correlation between the FFDM measurements and the pathological findings was not statistically significant, with questionable consistency (intraclass correlation coefficient = 0.488-0.598). Agreement with the pathological findings was narrower for CESM measurements than for FFDM measurements. Interobserver agreement was higher for CESM than for FFDM (0.94 vs. 0.88). Conclusion: CESM is a feasible means of evaluating residual tumor size after NAC, showing a good correlation and good agreement with pathological findings. For CESM measurements, the interobserver agreement was excellent.
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Schellhaas, Barbara, Lukas Pfeifer, Christian Kielisch, Ruediger Goertz, Markus Neurath, and Deike Strobel. "Interobserver Agreement for Contrast-Enhanced Ultrasound (CEUS)-Based Standardized Algorithms for the Diagnosis of Hepatocellular Carcinoma in High-Risk Patients." Ultraschall in der Medizin - European Journal of Ultrasound 39, no. 06 (June 7, 2018): 667–74. http://dx.doi.org/10.1055/a-0612-7887.

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Abstract Objectives This pilot study aimed at assessing interobserver agreement with two contrast-enhanced ultrasound (CEUS) algorithms for the diagnosis of hepatocellular carcinoma (HCC) in high-risk patients. Methods Focal liver lesions in 55 high-risk patients were assessed independently by three blinded observers with two standardized CEUS algorithms: ESCULAP (Erlanger Synopsis of Contrast-Enhanced Ultrasound for Liver Lesion Assessment in Patients at risk) and ACR-CEUS-LI-RADSv.2016 (American College of Radiology CEUS-Liver Imaging Reporting and Data System). Lesions were categorized according to size and ultrasound contrast enhancement in the arterial, portal-venous and late phase. Interobserver agreement for assessment of enhancement pattern and categorization was compared between both CEUS algorithms. Additionally, diagnostic accuracy for the definitive diagnosis of HCC was compared. Histology and/or CE-MRI and follow-up served as reference standards. Results 55 patients were included in the study (male/female, 44/ 11; mean age: 65.9 years). 90.9 % had cirrhosis. Histological findings were available in 39/55 lesions (70.9 %). Reference standard of the 55 lesions revealed 48 HCCs, 2 intrahepatic cholangiocellular carcinomas (ICCs), and 5 non-HCC-non-ICC lesions. Interobserver agreement was moderate to substantial for arterial phase hyperenhancement (ĸ = 0.53 – 0.67), and fair to moderate for contrast washout in the portal-venous or late phase (ĸ = 0.33 – 0.53). Concerning the CEUS-based algorithms, the interreader agreement was substantial for the ESCULAP category (ĸ = 0.64 – 0.68) and fair for the CEUS-LI-RADS® category (ĸ = 0.3 – 0.39). Disagreement between observers was mostly due to different perception of washout. Conclusion Interobserver agreement is better for ESCULAP than for CEUS-LI-RADS®. This is mostly due to the fact that perception of contrast washout varies between different observers. However, interobserver agreement is good for arterial phase hyperenhancement, which is the key diagnostic feature for the diagnosis of HCC with CEUS in the cirrhotic liver.
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Massri-Pugin, Jafet, Sergio Morales, Pablo Mery, Cristián A. Ruz, Agustin Vial Wood, Joaquin Palma, and Andres Villa. "Shortcomings of Posterior Malleolus Fractures Classifications: A Independent Inter and Intra-Rater Agreement Study Was Proposed." Foot & Ankle Orthopaedics 7, no. 4 (October 2022): 2473011421S0079. http://dx.doi.org/10.1177/2473011421s00791.

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Category: Ankle Introduction/Purpose: Posterior malleolus fractures (PMFs) occur up to 50% of ankle fractures. Several classification systems exist for their characterization, specially under computed tomography (CT). However, those classifications do not report or report incompletely the level of agreement and reliability. Also, there are no studies that have validated those classifications further. The aim of this study was to perform an independent agreement study for comparing the level of agreement of Haraguchi, Bartonícek/Rammelt, and Mason's classification; among physicians with different levels of orthopaedic training in the management of PMFs. Methods: This study was designed according to the 'Guidelines for Reporting Reliability and Agreement Studies' ('GRASS'). Ninety-four CT scans of patients with ankle fractures that had PMF were included. Exclusion criteria were previous history of fracture, surgery, tumors, and infections of the ankle; and the presence of pilon fracture. PMF were assessed by six evaluators (3 foot and ankle surgeons and 3 orthopaedic surgery residents) according to Haraguchi, Bartonícek/Rammelt; and Mason 's classifications. All images were reassessed by the same evaluators in a random sequence three weeks later. The new sequence of CT images was done by one of the authors, who did not participate in the evaluation of the cases. The Kappa (k) oefficient was used to determine the intra and interobserver agreement. Statistical significance was established using p < .05, with a 95% confidence interval (CI). Results: We performed a total of 564 observations for each classification. The overall interobserver agreement was moderate for all classifications, with a (k) value of 0.52 (95% CI: 0.43-0.61) for Haraguchi, 0.53 (95% CI: 0.46-0.61) for Bartonícek/Rammelt; and 0.54 (95% CI: 0.47-0.62) for Mason's classification, without significant differences between them. Meanwhile, the overall interobserver agreement was substantial for all classifications, with a (k) value of 0.70 (95% CI: 0.64-0.75) for Haraguchi, 0.73 (95% CI: 0.69-0.78) for Bartonícek/Rammelt; and 0.73 (95% CI: 0.69-0.78) for Mason's classification, without significant differences between them. No differences were found in the inter and intraobserver agreement among orthopaedic surgeons and residents. Conclusion: This is the first agreement study that compares the most utilized classifications for PMFs, according to 'GRRAS'. Our results showed substantial intraobserver agreement, but only moderate interobserver agreement for all classifications; limiting adequate communication in clinical and research field. These findings did not change regardless of the level of experience of the evaluators. Due to moderate level of agreement and that no classification is superior to the others, we estimate the need to generate a new classification for PMFs, that gives a higher level of agreement, as well as, orientation to the surgeon during the decision-making process.
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Jacquot, Amalia, Céline Chauleur, Anne-Sophie Russel-Robillard, Fabien Tinquaut, Sandrine Sotton, Nicolas Magne, and Guillaume Etievent. "MRI accuracy and interobserver agreement in locally advanced cervix carcinoma." British Journal of Radiology 94, no. 1125 (September 1, 2021): 20210197. http://dx.doi.org/10.1259/bjr.20210197.

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Objectives: The main standard of care for locally advanced cervix carcinoma (LACC) is radiochemotherapy (RCT) followed by brachytherapy. A surgical approach may still be discussed based on pelvic MRI-derived residual tumour evaluation. As no interobserver agreement study has ever been conducted to our knowledge, the aim of the present study was to report on pelvic MRI accuracy and interobserver agreement in LACC. Methods: We carried out a retrospective study in a French university hospital. Medical records of all consecutive patients treated with curative intent for LACC by RCT followed by brachytherapy and completion pelvic surgery between January 2014 and January 2020 were reviewed. Local response was assessed through pelvis MRI and histological analysis after completion surgery. MRI data were independently evaluated by two radiologists with varying experience. The two main interobserving criteria we used were complete response and residual tumour. Results: 23 patients fulfilled the inclusion criteria. Agreement between the junior and senior radiologist was moderate to strong. Indeed, regarding main criteria, κ was 0.65 for complete response and 0.57 for residual tumour. Interestingly, the present study shows a lower sensitivity whatever the radiologists than in the international literature. Conclusion: The present study highlights a low interobserver variability regarding pelvic MRI in the assessment of RCT followed by brachytherapy in LACC. Yet, sensitivity was lower than in literature. Advances in knowledge: Radiology is part of treatment decision-making, the issue of heterogeneity regarding radiologists’ training and experience to cancer (sensitivity and specificity) turns essential, so does MRI accuracy.
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Carballo, Gloria, Elvira Mendoza, and Nieves Valencia-Naranjo. "Interobserver Agreement of Perceived Intelligibility of |r̄| in Children." Perceptual and Motor Skills 84, no. 3 (June 1997): 1099–104. http://dx.doi.org/10.2466/pms.1997.84.3.1099.

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This study was designed to test whether independent listeners could correctly classify 162 stimuli (words) that started with a multiple trill, |r̄|, followed by a vowel |a|. The sounds were from 27 Spanish children between the ages of 3.0 and 6.6 years, pronouncing Spanish words current in their vocabulary. Twelve listeners were presented with the recordings of the children's |r̄| production and were instructed to rate the intelligibility of the pronounced sound as high, medium, or low. Inter-rater agreement ranged from 85 to 96%. Analyses of variance for each of the three production categories showed that there were significant differences, so it seems possible to classify the words starting with a trilled |r̄| based on auditory-perceptual features into three broad categories according to intelligibility.
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Mendes, Roberto Miguel Gonçalves, Manuel Lourenço Nunes, Miguel Castelo-Branco Craveiro Sousa, Ricardo Bruno Rodrigues Gonçalves, Pascoal Nogueira Fernandes, and Alexandre José Oliveira Gomes. "Validation of the ICU Mobility Scale for Nursing Use: Portuguese Multicentric Observational Study." Journal of Nursing Measurement 29, no. 1 (December 17, 2020): 80–93. http://dx.doi.org/10.1891/jnm-d-19-00062.

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Background and PurposeMobilization of critical patients should be precocious and the inclusion of nursing in this task can be decisive in paradigm shift. The purpose of this study was to validate the Portuguese version of the intensive care unit Mobility Scale for nursing use.MethodsProspective multicenter observational study. Patients' mobility was evaluated by rehabilitation nurses in order to determine interobserver agreement. The validation criteria was tested by determining the correlation between the evaluation results of mobility, strength, and functionality levels at discharge.ResultsGood interobserver agreement (R = 0.98; K = 0.76). Positive correlation with muscle strength (R = 0.77) and functionality (R = 0.85) levels at discharge.ConclusionsBased on the correlations observed the scale is a valid instrument for nurses and could be a useful tool for routine use. More research is recommended to make the results more robust.
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Atiya, Monika, Tobias Kurth, Klaus Berger, Julie E. Buring, and Carlos S. Kase. "Interobserver Agreement in the Classification of Stroke in the Women’s Health Study." Stroke 34, no. 2 (February 2003): 565–67. http://dx.doi.org/10.1161/01.str.0000054159.21017.7c.

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45

Duncan, Lyn M., Marianne Berwick, Jan A. Bruijn, H. Randolph Byers, Martin C. Mihm, and Raymond L. Barnhill. "Histopathologic Recognition and Grading of Dysplastic Melanocytic Nevi: An Interobserver Agreement Study." Journal of Investigative Dermatology 100, no. 3 (March 1993): 318S—321S. http://dx.doi.org/10.1111/1523-1747.ep12470215.

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46

Berger, Klaus, Carlos S. Kase, and Julie E. Buring. "Interobserver Agreement in the Classification of Stroke in the Physicians’ Health Study." Stroke 27, no. 2 (February 1996): 238–42. http://dx.doi.org/10.1161/01.str.27.2.238.

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47

Loizou, L., N. Albiin, C. Ansorge, M. Andersson, R. Segersvärd, B. Leidner, A. Sundin, L. Lundell, and N. Kartalis. "Computed tomography staging of pancreatic cancer: A validation study addressing interobserver agreement." Pancreatology 13, no. 6 (November 2013): 570–75. http://dx.doi.org/10.1016/j.pan.2013.09.004.

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48

Duncan, Lyn M., Marianne Berwick, Jan A. Bruijn, H. Randolph Byers, Martin C. Mihm, and Raymond L. Barnhill. "Histopathologic Recognition and Grading of Dysplastic Melanocytic Nevi: An Interobserver Agreement Study." Journal of Investigative Dermatology 100, no. 3 (March 1993): S318—S321. http://dx.doi.org/10.1038/jid.1993.55.

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Risio, Mauro, Carlo Senore, Paola Cassoni, Alessandro Repici, and Cesare Hassan. "Tu1421 Interobserver Agreement Among Pathologists in Discriminating Serrated Lesions: the User Study." Gastrointestinal Endoscopy 79, no. 5 (May 2014): AB533. http://dx.doi.org/10.1016/j.gie.2014.02.867.

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Pezzoli, Alessandro, Renato Cannizzaro, Marco Pennazio, Emanuele Rondonotti, Laura Zancanella, Nadia Fusetti, Marzia Simoni, et al. "Interobserver agreement in describing video capsule endoscopy findings: A multicentre prospective study." Digestive and Liver Disease 43, no. 2 (February 2011): 126–31. http://dx.doi.org/10.1016/j.dld.2010.07.007.

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