title: Interobserver reliability and accuracy of cranial ultrasound scanning interpretation in premature infants.
abstract: OBJECTIVE
  To assess interobserver reliability between 2 central readers of cranial ultrasound scanning (CUS) and accuracy of local, compared with central, interpretations.
  
  
  METHODS
  The study was a retrospective analysis of CUS data from the National Institute of Child Health and Human Development (NICHD) trial of inhaled nitric oxide for premature infants. Interobserver reliability of 2 central readers was assessed with kappa or weighted kappa. Accuracy of local, compared with central, interpretations was assessed by using sensitivity and specificity.
  
  
  RESULTS
  CUS from 326 infants had both central reader and local interpretations. Central reader agreement for grade 3/4 intraventricular hemorrhage (IVH), grade 3/4 IVH or periventricular leukomalacia (PVL), grade of IVH, and degree of ventriculomegaly was very good (kappa = 0.84, 0.81, 0.79, and 0.75, respectively). Agreement was poor for lower grade IVH and for PVL alone. Local interpretations were highly accurate for grade 3/4 IVH or PVL (sensitivity, 87%-90%; specificity, 92%-93%), but sensitivity was poor-to-fair for grade 1/2 IVH (48%-68%) and PVL (20%-44%).
  
  
  CONCLUSIONS
  Our findings demonstrate reliability and accuracy of highly unfavorable CUS findings, but suggest caution when interpreting mild to moderate IVH or white matter injury.
authors.affiliation: Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Palo Alto, CA 94304, USA. srhintz@stanford.edu
authors.forename: Susan R
authors.initials: SR
authors.lastname: Hintz
authors.forename: Thomas
authors.initials: T
authors.lastname: Slovis
authors.forename: Dorothy
authors.initials: D
authors.lastname: Bulas
authors.forename: Krisa P
authors.initials: KP
authors.lastname: Van Meurs
authors.forename: Rebecca
authors.initials: R
authors.lastname: Perritt
authors.forename: David K
authors.initials: DK
authors.lastname: Stevenson
authors.forename: W Kenneth
authors.initials: WK
authors.lastname: Poole
authors.forename: Abhik
authors.initials: A
authors.lastname: Das
authors.forename: Rosemary D
authors.initials: RD
authors.lastname: Higgins
mesh_terms: D001993:Bronchodilator Agents; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging* / Q000473:pathology; D002552:Cerebral Ventricles / Q000000981:diagnostic imaging* / Q000473:pathology; D004108:Dilatation, Pathologic / Q000473:pathology; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007969:Leukomalacia, Periventricular / Q000000981:diagnostic imaging* / Q000473:pathology; D009569:Nitric Oxide / Q000627:therapeutic use; D015588:Observer Variation; D011237:Predictive Value of Tests; D012131:Respiratory Insufficiency / Q000188:drug therapy; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography
chemical_list: D001993:Bronchodilator Agents; D009569:Nitric Oxide