Interobserver agreement for EUS findings in familial pancreatic-cancer kindreds.
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.
Topazian
Mark
M
Mayo Clinic, Rochester, Minnesota 55905, and University of Washington, Seattle, Washington, USA.
Enders
Felicity
F
Kimmey
Michael
M
Brand
Randall
R
Chak
Amitabh
A
Clain
Jonathan
J
Cunningham
John
J
Eloubeidi
Mohamad
M
Gerdes
Hans
H
Gress
Frank
F
Jagannath
Sanjay
S
Kantsevoy
Sergey
S
LeBlanc
Julia Kim
JK
Levy
Michael
M
Lightdale
Charles
C
Romagnuolo
Joseph
J
Saltzman
John R
JR
Savides
Thomas
T
Wiersema
Maurits
M
Woodward
Timothy
T
Petersen
Gloria
G
Canto
Marcia
M
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