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Interpretation of Thoracic Radiography Shows Large Discrepancies Depending on the Qualification of the Physician—Quantitative Evaluation of Interobserver Agreement in a Representative Emergency Department Scenario

(1) Background: Chest radiography (CXR) is still a key diagnostic component in the emergency department (ED). Correct interpretation is essential since some pathologies require urgent treatment. This study quantifies potential discrepancies in CXR analysis between radiologists and non-radiology phys...

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Autores principales: Rudolph, Jan, Fink, Nicola, Dinkel, Julien, Koliogiannis, Vanessa, Schwarze, Vincent, Goller, Sophia, Erber, Bernd, Geyer, Thomas, Hoppe, Boj Friedrich, Fischer, Maximilian, Ben Khaled, Najib, Jörgens, Maximilian, Ricke, Jens, Rueckel, Johannes, Sabel, Bastian Oliver
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8534346/
https://www.ncbi.nlm.nih.gov/pubmed/34679566
http://dx.doi.org/10.3390/diagnostics11101868
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author Rudolph, Jan
Fink, Nicola
Dinkel, Julien
Koliogiannis, Vanessa
Schwarze, Vincent
Goller, Sophia
Erber, Bernd
Geyer, Thomas
Hoppe, Boj Friedrich
Fischer, Maximilian
Ben Khaled, Najib
Jörgens, Maximilian
Ricke, Jens
Rueckel, Johannes
Sabel, Bastian Oliver
author_facet Rudolph, Jan
Fink, Nicola
Dinkel, Julien
Koliogiannis, Vanessa
Schwarze, Vincent
Goller, Sophia
Erber, Bernd
Geyer, Thomas
Hoppe, Boj Friedrich
Fischer, Maximilian
Ben Khaled, Najib
Jörgens, Maximilian
Ricke, Jens
Rueckel, Johannes
Sabel, Bastian Oliver
author_sort Rudolph, Jan
collection PubMed
description (1) Background: Chest radiography (CXR) is still a key diagnostic component in the emergency department (ED). Correct interpretation is essential since some pathologies require urgent treatment. This study quantifies potential discrepancies in CXR analysis between radiologists and non-radiology physicians in training with ED experience. (2) Methods: Nine differently qualified physicians (three board-certified radiologists [BCR], three radiology residents [RR], and three non-radiology residents involved in ED [NRR]) evaluated a series of 563 posterior-anterior CXR images by quantifying suspicion for four relevant pathologies: pleural effusion, pneumothorax, pneumonia, and pulmonary nodules. Reading results were noted separately for each hemithorax on a Likert scale (0–4; 0: no suspicion of pathology, 4: safe existence of pathology) adding up to a total of 40,536 reported pathology suspicions. Interrater reliability/correlation and Kruskal–Wallis tests were performed for statistical analysis. (3) Results: While interrater reliability was good among radiologists, major discrepancies between radiologists’ and non-radiologists’ reading results could be observed in all pathologies. Highest overall interrater agreement was found for pneumothorax detection and lowest agreement in raising suspicion for malignancy suspicious nodules. Pleural effusion and pneumonia were often suspected with indifferent choices (1–3). In terms of pneumothorax detection, all readers mainly decided for a clear option (0 or 4). Interrater reliability was usually higher when evaluating the right hemithorax (all pathologies except pneumothorax). (4) Conclusions: Quantified CXR interrater reliability analysis displays a general uncertainty and strongly depends on medical training. NRR can benefit from radiology reporting in terms of time efficiency and diagnostic accuracy. CXR evaluation of long-time trained ED specialists has not been tested.
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spelling pubmed-85343462021-10-23 Interpretation of Thoracic Radiography Shows Large Discrepancies Depending on the Qualification of the Physician—Quantitative Evaluation of Interobserver Agreement in a Representative Emergency Department Scenario Rudolph, Jan Fink, Nicola Dinkel, Julien Koliogiannis, Vanessa Schwarze, Vincent Goller, Sophia Erber, Bernd Geyer, Thomas Hoppe, Boj Friedrich Fischer, Maximilian Ben Khaled, Najib Jörgens, Maximilian Ricke, Jens Rueckel, Johannes Sabel, Bastian Oliver Diagnostics (Basel) Article (1) Background: Chest radiography (CXR) is still a key diagnostic component in the emergency department (ED). Correct interpretation is essential since some pathologies require urgent treatment. This study quantifies potential discrepancies in CXR analysis between radiologists and non-radiology physicians in training with ED experience. (2) Methods: Nine differently qualified physicians (three board-certified radiologists [BCR], three radiology residents [RR], and three non-radiology residents involved in ED [NRR]) evaluated a series of 563 posterior-anterior CXR images by quantifying suspicion for four relevant pathologies: pleural effusion, pneumothorax, pneumonia, and pulmonary nodules. Reading results were noted separately for each hemithorax on a Likert scale (0–4; 0: no suspicion of pathology, 4: safe existence of pathology) adding up to a total of 40,536 reported pathology suspicions. Interrater reliability/correlation and Kruskal–Wallis tests were performed for statistical analysis. (3) Results: While interrater reliability was good among radiologists, major discrepancies between radiologists’ and non-radiologists’ reading results could be observed in all pathologies. Highest overall interrater agreement was found for pneumothorax detection and lowest agreement in raising suspicion for malignancy suspicious nodules. Pleural effusion and pneumonia were often suspected with indifferent choices (1–3). In terms of pneumothorax detection, all readers mainly decided for a clear option (0 or 4). Interrater reliability was usually higher when evaluating the right hemithorax (all pathologies except pneumothorax). (4) Conclusions: Quantified CXR interrater reliability analysis displays a general uncertainty and strongly depends on medical training. NRR can benefit from radiology reporting in terms of time efficiency and diagnostic accuracy. CXR evaluation of long-time trained ED specialists has not been tested. MDPI 2021-10-11 /pmc/articles/PMC8534346/ /pubmed/34679566 http://dx.doi.org/10.3390/diagnostics11101868 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Rudolph, Jan
Fink, Nicola
Dinkel, Julien
Koliogiannis, Vanessa
Schwarze, Vincent
Goller, Sophia
Erber, Bernd
Geyer, Thomas
Hoppe, Boj Friedrich
Fischer, Maximilian
Ben Khaled, Najib
Jörgens, Maximilian
Ricke, Jens
Rueckel, Johannes
Sabel, Bastian Oliver
Interpretation of Thoracic Radiography Shows Large Discrepancies Depending on the Qualification of the Physician—Quantitative Evaluation of Interobserver Agreement in a Representative Emergency Department Scenario
title Interpretation of Thoracic Radiography Shows Large Discrepancies Depending on the Qualification of the Physician—Quantitative Evaluation of Interobserver Agreement in a Representative Emergency Department Scenario
title_full Interpretation of Thoracic Radiography Shows Large Discrepancies Depending on the Qualification of the Physician—Quantitative Evaluation of Interobserver Agreement in a Representative Emergency Department Scenario
title_fullStr Interpretation of Thoracic Radiography Shows Large Discrepancies Depending on the Qualification of the Physician—Quantitative Evaluation of Interobserver Agreement in a Representative Emergency Department Scenario
title_full_unstemmed Interpretation of Thoracic Radiography Shows Large Discrepancies Depending on the Qualification of the Physician—Quantitative Evaluation of Interobserver Agreement in a Representative Emergency Department Scenario
title_short Interpretation of Thoracic Radiography Shows Large Discrepancies Depending on the Qualification of the Physician—Quantitative Evaluation of Interobserver Agreement in a Representative Emergency Department Scenario
title_sort interpretation of thoracic radiography shows large discrepancies depending on the qualification of the physician—quantitative evaluation of interobserver agreement in a representative emergency department scenario
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8534346/
https://www.ncbi.nlm.nih.gov/pubmed/34679566
http://dx.doi.org/10.3390/diagnostics11101868
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