title: Vibration response imaging: evaluation of rater agreement in healthy subjects and subjects with pneumonia.
abstract: BACKGROUND
  We evaluated pulmonologists variability in the interpretation of Vibration response imaging (VRI) obtained from healthy subjects and patients hospitalized for community acquired pneumonia.
  
  
  METHODS
  The present is a prospective study conducted in a tertiary university hospital. Twenty healthy subjects and twenty three pneumonia cases were included in this study. Six pulmonologists blindly analyzed images of normal subjects and pneumonia cases and evaluated different aspects of VRI images related to the quality of data acquisition, synchronization of the progression of breath sound distribution and agreement between the maximal energy frame (MEF) of VRI (which is the maximal geographical area of lung vibrations produced at maximal inspiration) and chest radiography. For qualitative assessment of VRI images, the raters' evaluations were analyzed by degree of consistency and agreement.
  
  
  RESULTS
  The average value for overall identical evaluations of twelve features of the VRI image evaluation, ranged from 87% to 95% per rater (94% to 97% in control cases and from 79% to 93% per rater in pneumonia cases). Inter-rater median (IQR) agreement was 91% (82-96). The level of agreement according to VRI feature evaluated was in most cases over 80%; intra-class correlation (ICC) obtained by using a model of subject/rater for the averaged features was overall 0.86 (0.92 in normal and 0.73 in pneumonia cases).
  
  
  CONCLUSIONS
  Our findings suggest good agreement in the interpretation of VRI data between different raters. In this respect, VRI might be helpful as a radiation free diagnostic tool for the management of pneumonia.
authors.affiliation: Department of Critical Care Medicine, University Hospital Thessaly, Larissa, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Bartziokas
authors.forename: Christos
authors.initials: C
authors.lastname: Daenas
authors.forename: Sebastien
authors.initials: S
authors.lastname: Preau
authors.forename: Paris
authors.initials: P
authors.lastname: Zygoulis
authors.forename: Apostolos
authors.initials: A
authors.lastname: Triantaris
authors.forename: Theodora
authors.initials: T
authors.lastname: Kerenidi
authors.forename: Demosthenes
authors.initials: D
authors.lastname: Makris
authors.forename: Konstantinos I
authors.initials: KI
authors.lastname: Gourgoulianis
authors.forename: Zoe
authors.initials: Z
authors.lastname: Daniil
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D001314:Auscultation / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012135:Respiratory Sounds; D012680:Sensitivity and Specificity; D014732:Vibration