title: Interobserver variability in the assessment of CT imaging features of traumatic brain injury.
abstract: The goal of our study was to determine the interobserver variability between observers with different backgrounds and experience when interpreting computed tomography (CT) imaging features of traumatic brain injury (TBI). We retrospectively identified a consecutive series of 50 adult patients admitted at our institution with a suspicion of TBI, and displaying a Glasgow Coma Scale score < or =12. Noncontrast CT (NCT) studies were anonymized and sent to five reviewers with different backgrounds and levels of experience, who independently reviewed each NCT scan. Each reviewer assessed multiple CT imaging features of TBI and assigned every NCT scan a Marshall and a Rotterdam grading score. The interobserver agreement and coefficient of variation were calculated for individual CT imaging features of TBI as well as for the two scores. Our results indicated that the imaging review by both neuroradiologists and neurosurgeons were consistent with each other. The kappa coefficient of agreement for all CT characteristics showed no significant difference in interpretation between the neurosurgeons and neuroradiologists. The average Bland and Altman coefficients of variation for the Marshall and Rotterdam classification systems were 12.7% and 21.9%, respectively, which indicates acceptable agreement among all five reviewers. In conclusion, there is good interobserver reproducibility between neuroradiologists and neurosurgeons in the interpretation of CT imaging features of TBI and calculation of Marshall and Rotterdam scores.
authors.affiliation: Department of Radiology, Neuroradiology Section, University of California-San Francisco , San Francisco, California 94143-0628, USA.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Chun
authors.forename: Geoffrey T
authors.initials: GT
authors.lastname: Manley
authors.forename: Shirley I
authors.initials: SI
authors.lastname: Stiver
authors.forename: Ashley H
authors.initials: AH
authors.lastname: Aiken
authors.forename: Nicholas
authors.initials: N
authors.lastname: Phan
authors.forename: Vincent
authors.initials: V
authors.lastname: Wang
authors.forename: Michele
authors.initials: M
authors.lastname: Meeker
authors.forename: Su-Chun
authors.initials: SC
authors.lastname: Cheng
authors.forename: A D
authors.initials: AD
authors.lastname: Gean
authors.forename: Max
authors.initials: M
authors.lastname: Wintermark
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D055815:Young Adult