Display options
Cite
Siddiqui UT, Khan AF, Shamim MS, et al. Inter-observer variability in diagnosing radiological features of aneurysmal subarachnoid hemorrhage; a preliminary single centre study comparing observers from different specialties and levels of training. Surg Neurol Int. 2014;5:96doi: 10.4103/2152-7806.134654.
Siddiqui, U. T., Khan, A. F., Shamim, M. S., Hamid, R. S., Alam, M. M., & Emaduddin, M. (2014). Inter-observer variability in diagnosing radiological features of aneurysmal subarachnoid hemorrhage; a preliminary single centre study comparing observers from different specialties and levels of training. Surgical neurology international, 596. https://doi.org/10.4103/2152-7806.134654
Siddiqui, Usman T, et al. "Inter-observer variability in diagnosing radiological features of aneurysmal subarachnoid hemorrhage; a preliminary single centre study comparing observers from different specialties and levels of training." Surgical neurology international vol. 5 (2014): 96. doi: https://doi.org/10.4103/2152-7806.134654
Siddiqui UT, Khan AF, Shamim MS, Hamid RS, Alam MM, Emaduddin M. Inter-observer variability in diagnosing radiological features of aneurysmal subarachnoid hemorrhage; a preliminary single centre study comparing observers from different specialties and levels of training. Surg Neurol Int. 2014 Jun 17;5:96. doi: 10.4103/2152-7806.134654. eCollection 2014. PMID: 25024896; PMCID: PMC4093736.
Copy Download .nbib Format: NLM
Share it on

Surg Neurol Int. 2014 Jun 17;5:96. doi: 10.4103/2152-7806.134654. eCollection 2014.

Inter-observer variability in diagnosing radiological features of aneurysmal subarachnoid hemorrhage; a preliminary single centre study comparing observers from different specialties and levels of training.

Surgical neurology international

Usman T Siddiqui, Anjum F Khan, Muhammad Shahzad Shamim, Rana Shoaib Hamid, Muhammad Mehboob Alam, Muhammad Emaduddin

Affiliations

  1. Section of Neurosurgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
  2. Department of Radiology, Aga Khan University Hospital, Karachi, Pakistan.

PMID: 25024896 PMCID: PMC4093736 DOI: 10.4103/2152-7806.134654

Abstract

BACKGROUND: A noncontrast computed tomography (CT) scan remains the initial radiological investigation of choice for a patient with suspected aneurysmal subarachnoid hemorrhage (aSAH). This initial scan may be used to derive key information about the underlying aneurysm which may aid in further management. The interpretation, however, is subject to the skill and experience of the interpreting individual. The authors here evaluate the interpretation of such CT scans by different individuals at different levels of training, and in two different specialties (Radiology and Neurosurgery).

METHODS: Initial nonontrast CT scan of 35 patients with aSAH was evaluated independently by four different observers. The observers selected for the study included two from Radiology and two from Neurosurgery at different levels of training; a resident currently in mid training and a resident who had recently graduated from training of each specialty. Measured variables included interpreter's suspicion of presence of subarachnoid blood, side of the subarachnoid hemorrhage, location of the aneurysm, the aneurysm's proximity to vessel bifurcation, number of aneurysm(s), contour of aneurysm(s), presence of intraventricular hemorrhage (IVH), intracerebral hemorrhage (ICH), infarction, hydrocephalus and midline shift. To determine the inter-observer variability (IOV), weighted kappa values were calculated.

RESULTS: There was moderate agreement on most of the CT scan findings among all observers. Substantial agreement was found amongst all observers for hydrocephalus, IVH, and ICH. Lowest agreement rates were seen in the location of aneurysm being supra or infra tentorial. There were, however, some noteworthy exceptions. There was substantial to almost perfect agreement between the radiology graduate and radiology resident on most CT findings. The lowest agreement was found between the neurosurgery graduate and the radiology graduate.

CONCLUSION: Our study suggests that although agreements were seen in the interpretation of some of the radiological features of aSAH, there is still considerable IOV in the interpretation of most features among physicians belonging to different levels of training and different specialties. Whether these might affect management or outcome is unclear.

Keywords: Aneurysm; computed tomography; inter-observer variability; subarachnoid hemorrhage

References

  1. Crit Care Med. 2000 Apr;28(4):984-90 - PubMed
  2. Neurosurgery. 2006 Mar;58(3 Suppl):S16-24; discussion Si-iv - PubMed
  3. J Neurosurg. 2011 Dec;115(6):1191-6 - PubMed
  4. Neuroradiology. 1999 Apr;41(4):261-4 - PubMed
  5. Stroke. 2012 Jun;43(6):1711-37 - PubMed
  6. Neurology. 2000 Jun 13;54(11):2156-8 - PubMed
  7. Stroke. 2001 Sep;32(9):2012-20 - PubMed
  8. Stroke. 1988 Oct;19(10):1250-6 - PubMed
  9. J Neurol. 2006 Sep;253(9):1217-20 - PubMed
  10. Neurol Res. 1996 Dec;18(6):487-94 - PubMed
  11. Neurosurg Focus. 2003 Oct 15;15(4):E6 - PubMed
  12. J Neurosurg. 1985 Sep;63(3):355-62 - PubMed
  13. Neuroradiology. 1994;36(1):17-9 - PubMed
  14. Neurology. 1987 Oct;37(10):1586-91 - PubMed

Publication Types