title: Effect of reader experience on variability, evaluation time and accuracy of coronary plaque detection with computed tomography coronary angiography.
abstract: OBJECTIVE
  To assess the effect of reader experience on variability, evaluation time and accuracy in the detection of coronary artery plaques with computed tomography coronary angiography (CTCA).
  
  
  METHODS
  Three independent, blinded readers with three different experience levels twice labelled 50 retrospectively electrocardiography (ECG)-gated contrast-enhanced dual-source CTCA data sets (15 female, age 67.3 +/- 10.4 years, range 46-86 years) indicating the presence or absence of coronary plaques. The evaluation times for the readings were recorded. Intra- and interobserver variability expressed as kappa statistics and sensitivity, specificity, and negative and positive predictive values were calculated for plaque detection, with a consensus reading of the three readers taken as the standard of reference. A bootstrap method was applied in the statistical analysis to account for clustering.
  
  
  RESULTS
  Significant correlations were found between reader experience and, respectively, evaluation times (r = -0.59, p < 0.05) and intraobserver variability (r = 0.73, p < 0.05). The evaluation time significantly differed among the readers (p < 0.05). The observer variability for plaque detection, compared with the consensus, varied between kappa = 0.582 and kappa = 0.802. Variability of plaque detection was significantly smaller (p < 0.05) and more accurate (p < 0.05) for the most experienced reader.
  
  
  CONCLUSIONS
  Reader experience significantly correlated with observer variability, evaluation time and accuracy of coronary plaque detection at CTCA.
authors.affiliation: Computer Vision Laboratory, ETH Zurich, Zurich, Switzerland.
authors.forename: Stefan C
authors.initials: SC
authors.lastname: Saur
authors.forename: Hatem
authors.initials: H
authors.lastname: Alkadhi
authors.forename: Paul
authors.initials: P
authors.lastname: Stolzmann
authors.forename: Stephan
authors.initials: S
authors.lastname: Baumüller
authors.forename: Sebastian
authors.initials: S
authors.lastname: Leschka
authors.forename: Hans
authors.initials: H
authors.lastname: Scheffel
authors.forename: Lotus
authors.initials: L
authors.lastname: Desbiolles
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Fuchs
authors.forename: Gábor
authors.initials: G
authors.lastname: Székely
authors.forename: Philippe C
authors.initials: PC
authors.lastname: Cattin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography / Q000379:methods; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods