title: Inter-observer agreement for abdominal CT in unselected patients with acute abdominal pain.
abstract: The level of inter-observer agreement of abdominal computed tomography (CT) in unselected patients presenting with acute abdominal pain at the Emergency Department (ED) was evaluated. Two hundred consecutive patients with acute abdominal pain were prospectively included. Multi-slice CT was performed in all patients with intravenous contrast medium only. Three radiologists independently read all CT examinations. They recorded specific radiological features and a final diagnosis on a case record form. We calculated the proportion of agreement and kappa values, for overall, urgent and frequently occurring diagnoses. The mean age of the evaluated patients was 46 years (range 19-94), of which 54% were women. Overall agreement on diagnoses was good, with a median kappa of 0.66. Kappa values for specific urgent diagnoses were excellent, with median kappa values of 0.84, 0.90 and 0.81, for appendicitis, diverticulitis and bowel obstruction, respectively. Abdominal CT has good inter-observer agreement in unselected patients with acute abdominal pain at the ED, with excellent agreement for specific urgent diagnoses as diverticulitis and appendicitis.
authors.affiliation: Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. a.vanranden@amc.uva.nl
authors.forename: Adrienne
authors.initials: A
authors.lastname: van Randen
authors.forename: Wytze
authors.initials: W
authors.lastname: Laméris
authors.forename: C Yung
authors.initials: CY
authors.lastname: Nio
authors.forename: Anje M
authors.initials: AM
authors.lastname: Spijkerboer
authors.forename: Mark A
authors.initials: MA
authors.lastname: Meier
authors.forename: Charlotte
authors.initials: C
authors.lastname: Tutein Nolthenius
authors.forename: Frank
authors.initials: F
authors.lastname: Smithuis
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Bossuyt
authors.forename: Marja A
authors.initials: MA
authors.lastname: Boermeester
authors.forename: Jaap
authors.initials: J
authors.lastname: Stoker
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging* / Q000209:etiology*; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005767:Gastrointestinal Diseases / Q000150:complications* / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011860:Radiography, Abdominal / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult