[RAD-sem] Carina Stenman: Articles and kappa

[Alexandr Malusek]

ABSTRACT

Background

Ultrasound examination of the abdomen is often a first choice at radiology
departments due to the lack of ionizing radiation. For diagnostic accuracy
and economic benefits there has been a need for new routines in this area
that incorporate the benefits of an radiographer or sonographer performing
a multitude of ultrasound examinations following strictly standardized
examination protocols and documentation forms made by cine-loops that will
give the radiologist access to all relevant information needed for an
accurate post-examination diagnosis.

Aim

The overall objective of this thesis was to evaluate the diagnostic
variability in examinations of the kidneys and liver that use a
standardized ultrasound method along with video documentation of the entire
examination and off-line review by radiologists. More specifically, we
wanted to compare the agreement between readers and between operators.

Design and method

This thesis is based on four quantitative studies using standardized
protocols for kidney, liver and gallbladder examinations. In paper I,
including 64 patients, and paper IV, including 98 patients, the patients
were prospectively enrolled and the examinations were retrospectively
reviewed. The patients in papers I and IV were examined by one radiographer
(sonographer) and one radiologist during the same session. In paper I,
findings using the standardized ultrasound method were compared with
traditional bedside assessments by a radiologist. In paper IV, the patients
were examined using only the standardized method. In paper II, including 98
patients, and in paper III, including 115 patients, the patients were
examined by one sonographer using the standardized method and the
examinations were reviewed by two or three radiologists.

Results

In paper I, no significant systematic differences were found between the
findings using the standardized method and the traditional bedside
assessment.

Paper II showed good intra- and inter-observer agreement between three
experienced radiologists when reviewing examinations conducted using the
standardized method.

In paper III we verified good inter-observer agreement between two
radiologists reviewing ultrasound examinations using the standardized
technique in patients who had undergone surgery for colorectal cancer.
Intravenous contrast was used and the injection of contrast medium
increased the visibility of liver lesions.

In paper IV, we observed that using a standardized cine-loop technique,
there was a slightly better inter-operator agreement than inter-reader
agreement.

Conclusion

The satisfactory agreement shown in all four studies suggests that the new
workflow method using standardized ultrasound examinations and stored
cine-loops, performed by a radiographer or sonographer and analyzed
off-line by a radiologist, is a promising technique. The results are less
affected when a radiologist examiner is replaced by a radiographer or
sonographer than when the reviewer is replaced by a different radiologist.

Keywords Intra- and inter-observer agreement, standardized method,
cine-loop imaging, renal and liver sonography, ultrasound

---------- Forwarded message ---------
From: Ressner Marcus <Marcus.Ressner at regionostergotland.se>
Date: Mon, Jan 18, 2016 at 9:29 AM
Subject: SV: Radiofysik seminarie 20/1
To: Malusek Alexandr <alexandr.malusek at liu.se>


Hi!



Here is the kappa and articles.



/MarcusR
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