title: Reproducibility of detecting silent cerebral infarcts in pediatric sickle cell anemia.
abstract: Detecting silent cerebral infarcts on magnetic resonance images (MRIs) in children with sickle cell anemia is challenging, yet reproducibility of readings has not been examined in this population. We evaluated consensus rating, inter-, and intra-grader agreement associated with detecting silent cerebral infarct on screening MRI in the Silent Infarct Transfusion Trial. Three neuroradiologists provided consensus decisions for 1073 MRIs. A random sample of 53 scans was reanalyzed in blinded fashion. Agreement between first and second consensus ratings was substantial (κ = 0.70, P < .0001), as was overall intergrader agreement (κ = 0.76, P < .0001). In the test-retest sample, intragrader agreement ranged from κ of 0.57 to 0.76. Consensus decisions were more concordant when MRIs contained more than one larger lesions. Routine use of MRI to screen for silent cerebral infarcts in the research setting is reproducible in sickle cell anemia and agreement among neuroradiologists is sufficient.
authors.affiliation: Division of Hematology, Oncology & Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
authors.forename: Robert I
authors.initials: RI
authors.lastname: Liem
authors.affiliation: Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA.
authors.forename: Jingxia
authors.initials: J
authors.lastname: Liu
authors.affiliation: Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA.
authors.forename: Mae O
authors.initials: MO
authors.lastname: Gordon
authors.affiliation: Electronic Radiology Lab, Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA.
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Vendt
authors.affiliation: Department of Pediatrics, Washington University School of Medicine, Saint Louis, MO, USA.
authors.forename: Robert C
authors.initials: RC
authors.lastname: McKinstry
authors.affiliation: Division of Neuroradiology, Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Kraut
authors.affiliation: Pediatric Hematology, Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: John J
authors.initials: JJ
authors.lastname: Strouse
authors.affiliation: Division of Pediatric Neuroradiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: William S
authors.initials: WS
authors.lastname: Ball
authors.affiliation: Vanderbilt Meharry Center of Excellence in Sickle Cell Disease, Division of Pediatric Hematology/Oncology, Vanderbilt University Medical Center, Nashville, TN, USA m.debaun@vanderbilt.edu.
authors.forename: Michael R
authors.initials: MR
authors.lastname: DeBaun
mesh_terms: D000755:Anemia, Sickle Cell / Q000150:complications*; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000209:etiology*; D002648:Child; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D015203:Reproducibility of Results
keywords: reliability testing; sickle cell disease; stroke