Observer variability and the performance between faculties and residents: US criteria for benign and malignant thyroid nodules.
OBJECTIVE
To evaluate the interobserver variability and performance in the interpretation of ultrasonographic (US) findings of thyroid nodules.


METHODS
72 malignant nodules and 61 benign nodules were enrolled as part of this study. Five faculty radiologists and four residents independently performed a retrospective analysis of the US images. The observers received one training session after the first interpretation and then performed a secondary interpretation. Agreement was analyzed by Cohen's kappa statistic. Degree of performance was analyzed using receiver operating characteristic (ROC) curves.


RESULTS
Agreement between the faculties was fair-to-good for all criteria; however, between residents, agreement was poor-to-fair. The area under the ROC curves was 0.72, 0.62, and 0.60 for the faculties, senior residents, and junior residents, respectively. There was a significant difference in performance between the faculties and the residents (p < 0.05). There was a significant increase in the agreement for some criteria in the faculties and the senior residents after the training session, but no significant increase in the junior residents.


CONCLUSIONS
Independent reporting of thyroid US performed by residents is undesirable. A continuous and specialized resident training is essential to enhance the degree of agreement and performance.
Kim
Sung Hun
SH
Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul 137-701, Korea.
Park
Chang Suk
CS
Jung
So Lyung
SL
Kang
Bong Joo
BJ
Kim
Jee Young
JY
Choi
Jae Jung
JJ
Kim
Ye Il
YI
Oh
Jin Kyung
JK
Oh
Jung Suk
JS
Kim
Hanna
H
Jeong
Seung Hee
SH
Yim
Hyeon Woo
HW
D000328:Adult; D000368:Aged; D002983:Clinical Competence / Q000706:statistics & numerical data*; D003937:Diagnosis, Differential; D005180:Faculty, Medical / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012372:ROC Curve; D011871:Radiology / Q000193:education; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013961:Thyroid Gland / Q000000981:diagnostic imaging; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging*; D014463:Ultrasonography