title: Interobserver agreement for EUS findings in familial pancreatic-cancer kindreds.
abstract: BACKGROUND
  EUS is a promising modality for pancreatic-cancer screening in high-risk persons, including familial pancreatic-cancer (FPC) kindreds.
  
  
  OBJECTIVE
  To assess interobserver agreement for interpretation of EUS in persons at high risk for pancreatic cancer.
  
  
  METHODS
  Seventeen expert endosonographers blinded to patients' clinical history rated a "training set" of pancreatic EUS video clips for the presence of a normal examination, masses, cysts, and features of chronic pancreatitis. Clips included high-risk persons and controls (normal and various pancreatic diseases). The endosonographers then participated in a workshop on EUS findings in high-risk persons and drafted a consensus statement. Three months later, they blindly rated a "test set" composed of the same video clips.
  
  
  METHODS
  Interobserver agreement at baseline (training set) and after a consensus process (test set).
  
  
  RESULTS
  For the training set, interobserver agreement was good (kappa>or=0.4) for the presence of cysts and was fair to poor for all other rated EUS features and diagnosis of normal. There was no overall improvement in the test set. In both the training and test sets, agreement was worse for clips from FPC kindreds (kappa>or=0.4 for cysts and <0.4 for all other features) than for controls (kappa>or=0.4 for normal, cysts, masses, echogenic strands, and lobularity).
  
  
  CONCLUSIONS
  Video clips were not of identical image quality and duration as a clinical EUS examination.
  
  
  CONCLUSIONS
  There was fair to poor interobserver agreement for the interpretation of pancreatic EUS video clips from members of FPC kindreds. Agreement was not improved by a consensus process.
authors: Mayo Clinic, Rochester, Minnesota 55905, and University of Washington, Seattle, Washington, USA.
authors: Mark
authors: M
authors: Topazian
authors: Felicity
authors: F
authors: Enders
authors: Michael
authors: M
authors: Kimmey
authors: Randall
authors: R
authors: Brand
authors: Amitabh
authors: A
authors: Chak
authors: Jonathan
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authors: Clain
authors: John
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authors: Cunningham
authors: Mohamad
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authors: Eloubeidi
authors: Hans
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authors: Gerdes
authors: Frank
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authors: Gress
authors: Sanjay
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authors: Jagannath
authors: Sergey
authors: S
authors: Kantsevoy
authors: Julia Kim
authors: JK
authors: LeBlanc
authors: Michael
authors: M
authors: Levy
authors: Charles
authors: C
authors: Lightdale
authors: Joseph
authors: J
authors: Romagnuolo
authors: John R
authors: JR
authors: Saltzman
authors: Thomas
authors: T
authors: Savides
authors: Maurits
authors: M
authors: Wiersema
authors: Timothy
authors: T
authors: Woodward
authors: Gloria
authors: G
authors: Petersen
authors: Marcia
authors: M
authors: Canto
mesh_terms: D002983:Clinical Competence; D032921:Consensus; D004724:Endoscopy / Q000193:education; D019160:Endosonography; D006801:Humans; D015588:Observer Variation; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000235:genetics; D010580:Peutz-Jeghers Syndrome / Q000000981:diagnostic imaging / Q000235:genetics; D011237:Predictive Value of Tests; D015203:Reproducibility of Results