Interobserver Agreement between On-Call Radiology Resident and General Radiologist Interpretations of CT Pulmonary Angiograms and CT Venograms.
OBJECTIVE
To evaluate the interobserver agreement (IOA) between the initial radiology resident and the final staff radiologist reports of combined computed tomographic pulmonary angiograms (CTPA) and computed tomographic venograms (CTV) performed during on-call hours.


METHODS
Approval by the institutional review board was obtained. Six-hundred and ninety-six consecutive studies (CTPA or CTPA with CTV) performed during on-call hours and interpreted by 30 residents were identified. Radiology residents' reports were compared to the final staff reports. Three tests outcomes were considered (positive, P; negative, N; indeterminate, I). Discordant cases were reviews by a chest radiologist.


RESULTS
CTPAs were reported by staff radiologists as positive for pulmonary embolism (PE) in 18% (126/694), with a kappa of 0.81 (95% CI 0.77-0.86) with 3 outcomes (P, N, I), and a kappa of 0.89 (95% CI 0.85-0.94) with 2 outcomes (P, N). Regarding PE location, good concordance was observed for positive studies, with a kappa of 0.86 (95% CI 0.78 - 0.95). CTVs were reported as positive by staff radiologists in 8.5% (33/388), with a kappa of 0.66 (95% CI 0.55-0.77) with 3 outcomes (P, N, I), and a kappa of 0.89 (95% CI 0.8-1.0) with 2 outcomes (P, N). The IOA between residents and staff radiologists increased with increasing residency year level for CTPAs, but did not for CTVs.


CONCLUSIONS
Very good and good IOA were observed between resident and staff radiologist interpretations for CTPA and CTV, respectively, with tendency towards improved IOA as residency level of training increased for CTPA, but not for CTV.
Department of Radiology, McGill University Health Center, Montreal, Quebec, Canada.
Bahar
B
Tamjeedi
Department of Mathematics and Statistics, McGill Statistical Consulting Service, Montreal, Quebec, Canada.
José
J
Correa
Department of Radiology, McGill University Health Center, Montreal, Quebec, Canada.
Alexandre
A
Semionov
Department of Radiology, McGill University Health Center, Montreal, Quebec, Canada.
Benoît
B
Mesurolle
D000328:Adult; D000792:Angiography; D002983:Clinical Competence; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010820:Physicians / Q000706:statistics & numerical data; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging; D011871:Radiology / Q000379:methods*; D014057:Tomography, X-Ray Computed