title: Assessing the intra- and inter-reader reliability of dynamic ultrasound images in power Doppler ultrasonography.
abstract: OBJECTIVE
  To assess the intra-reader and inter-reader reliabilities of interpreting ultrasonography by several experts using video clips.
  
  
  METHODS
  99 video clips of healthy and rheumatic joints were recorded and delivered to 17 physician sonographers in two rounds. The intra-reader and inter-reader reliabilities of interpreting the ultrasound results were calculated using a dichotomous system (normal/abnormal) and a graded semiquantitative scoring system.
  
  
  RESULTS
  The video reading method worked well. 70% of the readers could classify at least 70% of the cases correctly as normal or abnormal. The distribution of readers answering correctly was wide. The most difficult joints to assess were the elbow, wrist, metacarpophalangeal (MCP) and knee joints. The intra-reader and inter-reader agreements on interpreting dynamic ultrasound images as normal or abnormal, as well as detecting and scoring a Doppler signal were moderate to good (kappa = 0.52-0.82).
  
  
  CONCLUSIONS
  Dynamic image assessment (video clips) can be used as an alternative method in ultrasonography reliability studies. The intra-reader and inter-reader reliabilities of ultrasonography in dynamic image reading are acceptable, but more definitions and training are needed to improve sonographic reproducibility.
authors.affiliation: Department of Internal Medicine, Mikkeli Central Hospital, Mikkeli, Finland. f.koski@fimnet.fi
authors.forename: J M
authors.initials: JM
authors.lastname: Koski
authors.forename: S
authors.initials: S
authors.lastname: Saarakkala
authors.forename: M
authors.initials: M
authors.lastname: Helle
authors.forename: U
authors.initials: U
authors.lastname: Hakulinen
authors.forename: J O
authors.initials: JO
authors.lastname: Heikkinen
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authors.initials: H
authors.lastname: Hermunen
authors.forename: P
authors.initials: P
authors.lastname: Balint
authors.forename: G A
authors.initials: GA
authors.lastname: Bruyn
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authors.lastname: Filippucci
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authors.lastname: Grassi
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authors.lastname: Iagnocco
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authors.lastname: Luosujärvi
authors.forename: B
authors.initials: B
authors.lastname: Manger
authors.forename: E
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authors.lastname: De Miguel
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authors.lastname: Naredo
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authors.lastname: Schmidt
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authors.initials: I
authors.lastname: Soini
authors.forename: M
authors.initials: M
authors.lastname: Szkudlarek
authors.forename: L
authors.initials: L
authors.lastname: Terslev
authors.forename: J
authors.initials: J
authors.lastname: Uson
authors.forename: S
authors.initials: S
authors.lastname: Vuoristo
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authors.initials: HR
authors.lastname: Ziswiler
mesh_terms: D001168:Arthritis / Q000000981:diagnostic imaging* / Q000473:pathology; D001706:Biopsy; D006801:Humans; D015588:Observer Variation; D015203:Reproducibility of Results; D013585:Synovitis / Q000000981:diagnostic imaging / Q000473:pathology; D018608:Ultrasonography, Doppler; D014741:Video Recording