title: Interobserver agreement on the radiological criteria of the International Panel on the diagnosis of multiple sclerosis.
abstract: We assessed the interobserver agreement on the radiological part of the International Panel (IP) criteria for the diagnosis of multiple sclerosis (MS), comprising the assessment of dissemination in space (DIS) and time (DIT) based exclusively on MRI. Four radiologists trained and four radiologists naive in the application of the IP criteria scored the fulfillment for DIS (i.e., > or =3 periventricular, > or =1 infratentorial, > or =1 juxtacortical, > or = 1 enhancing lesion or a total of > or =9 T2-weighted lesions) and DIT (presence of new or enhancing lesions at follow-up) in baseline and two follow-up scans from 20 patients suspected for having MS. The IP-trained radiologists agreed at least moderately on all assessments (kappa>0.40), whereas the IP-naive radiologists showed fair agreement (kappa<0.40) on five of 16 assessments. In the final conclusion on DIS and DIT, the IP-trained radiologists agreed substantially on both items (kappa=0.62 and kappa=0.60, respectively) compared with a fair agreement on DIS (kappa=0.29) and moderate agreement on DIT (kappa=0.52) among the IP-naive radiologists. Given the poor interobserver agreement among IP-naive observers, the new IP criteria for MS require additional training and should perhaps be simplified.
authors.affiliation: Department of Radiology, VU University Medical Centre, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands. T.Korteweg@vumc.nl
authors.forename: Tijmen
authors.initials: T
authors.lastname: Korteweg
authors.forename: Bernard M J
authors.initials: BM
authors.lastname: Uitdehaag
authors.forename: Dirk L
authors.initials: DL
authors.lastname: Knol
authors.forename: Robin H M
authors.initials: RH
authors.lastname: Smithuis
authors.forename: Paul R
authors.initials: PR
authors.lastname: Algra
authors.forename: Cees
authors.initials: C
authors.lastname: de Vries
authors.forename: Peter A
authors.initials: PA
authors.lastname: Poppe
authors.forename: Jan-Hein T M
authors.initials: JH
authors.lastname: van Waesberghe
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Bergers
authors.forename: Geert J
authors.initials: GJ
authors.lastname: Lycklama à Nijeholt
authors.forename: Chris H
authors.initials: CH
authors.lastname: Polman
authors.forename: Frederik
authors.initials: F
authors.lastname: Barkhof
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis*; D015588:Observer Variation