Reliability of the interpretation of coronary angiography by the simple visual method.
OBJECTIVE
Evaluation of inter and intraobserver reproducibility of by the visual method interpretation of cineangiogram in a clinically based context.


METHODS
Five interventional cardiologists analyzed 11 segments of 8 coronary cineangiograms at a two month apart sessions. The percent luminal reduction by the lesions were analyzed by two different classifications: in one (A) the lesions were graded in 0% = absent, 1-50% = mild, 51 - 69 = moderate, and > or = 70% = severe; the other classification (B) was a dichotomic one : <70% = nonsignificant and > or = 70%=significant lesions. The agreement were measured by the kappa (k) index.


RESULTS
Interobserver agreement was moderate for classification A (1st measurement, k = 0.36 - 0.63, k m = 0.49; 2nd measurement, k = 0.39-0.68, k m = 0.52) and good for classification B (1st measurement, k = 0.55-0.73, k m = 0.63; 2nd measurement, k = 0.37-0.82, k m = 0.61). Intraobserver levels of agreement were k = 0.57-0.95 for classification A and 0.62-1.0 for classification B.


CONCLUSIONS
The higher level of reproducibility obtained by adopting the dichotomous criteria usually considered for ischemic limits demonstrates that in the present clinical context, the reliability of the simple visual method is adequate for the identification of patients with clinically significant lesions and candidates for myocardial revascularization procedures.
Guimaraes
J A
JA
Hospital das Clínicas UFPE and Real Hospital Português, Recife. jang@realcor.com.br
Victor
E G
EG
de Britto Leite
M R
MR
Gomes
J M
JM
Victor Filho
E
E
Reyes Liveras
J
J
D002932:Cineangiography; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D006801:Humans; D015588:Observer Variation; D015203:Reproducibility of Results; D012720:Severity of Illness Index