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...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-10-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/11/10/1868 |
| _version_ | 1797514844855861248 |
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| author | Jan Rudolph Nicola Fink Julien Dinkel Vanessa Koliogiannis Vincent Schwarze Sophia Goller Bernd Erber Thomas Geyer Boj Friedrich Hoppe Maximilian Fischer Najib Ben Khaled Maximilian Jörgens Jens Ricke Johannes Rueckel Bastian Oliver Sabel |
| author_facet | Jan Rudolph Nicola Fink Julien Dinkel Vanessa Koliogiannis Vincent Schwarze Sophia Goller Bernd Erber Thomas Geyer Boj Friedrich Hoppe Maximilian Fischer Najib Ben Khaled Maximilian Jörgens Jens Ricke Johannes Rueckel Bastian Oliver Sabel |
| author_sort | Jan Rudolph |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-03-10T06:37:19Z |
| format | Article |
| id | doaj.art-238c7318807042fe98a70f828486a3d6 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T06:37:19Z |
| publishDate | 2021-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-238c7318807042fe98a70f828486a3d62023-11-22T17:58:01ZengMDPI AGDiagnostics2075-44182021-10-011110186810.3390/diagnostics11101868Interpretation of Thoracic Radiography Shows Large Discrepancies Depending on the Qualification of the Physician—Quantitative Evaluation of Interobserver Agreement in a Representative Emergency Department ScenarioJan Rudolph0Nicola Fink1Julien Dinkel2Vanessa Koliogiannis3Vincent Schwarze4Sophia Goller5Bernd Erber6Thomas Geyer7Boj Friedrich Hoppe8Maximilian Fischer9Najib Ben Khaled10Maximilian Jörgens11Jens Ricke12Johannes Rueckel13Bastian Oliver Sabel14Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, GermanyDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, GermanyDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, GermanyDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, GermanyDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, GermanyDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, GermanyDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, GermanyDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, GermanyDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, GermanyDepartment of Medicine I, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, GermanyDepartment of Medicine II, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, GermanyDepartment of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, GermanyDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, GermanyDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, GermanyDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany(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.https://www.mdpi.com/2075-4418/11/10/1868chest radiographyemergency departmentinterrater reliabilityradiologistsclinicians |
| spellingShingle | Jan Rudolph Nicola Fink Julien Dinkel Vanessa Koliogiannis Vincent Schwarze Sophia Goller Bernd Erber Thomas Geyer Boj Friedrich Hoppe Maximilian Fischer Najib Ben Khaled Maximilian Jörgens Jens Ricke Johannes Rueckel Bastian Oliver Sabel 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 Diagnostics chest radiography emergency department interrater reliability radiologists clinicians |
| 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 | chest radiography emergency department interrater reliability radiologists clinicians |
| url | https://www.mdpi.com/2075-4418/11/10/1868 |
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