Ultrasound grading of thyroid nodules using the BTA U-scoring guidelines - Is there evidence of intra-and interobserver variability?

IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Ultrasound Pub Date : 2021-05-01 Epub Date: 2020-11-16 DOI:10.1177/1742271X20971323
Michael Couzins, Stuart Forbes, Ganesh Vigneswaran, Indu Mitra, Elizabeth E Rutherford
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引用次数: 1

Abstract

Introduction: U-score ultrasound classification (graded U1-U5) is widely used to grade thyroid nodules based on benign and malignant sonographic features. It is well established that ultrasound is an operator-dependent imaging modality and thus more susceptible to subjective variances between operators when using imaging-based scoring systems. We aimed to assess whether there is any intra- or interobserver variability when U-scoring thyroid nodules and whether previous thyroid ultrasound experience has an effect on this variability.

Methods: A total of 14 ultrasound operators were identified (five experienced thyroid operators, five with intermediate experience and four with no experience) and were asked to U-score images from 20 thyroid cases shown as a single projection, with and without Doppler flow. The cases were subsequently rescored by the 14 operators after six weeks. The first and second round U-scores for the three operator groups were then analysed using Fleiss' kappa to assess interobserver variability and Cochran's Q test to determine any intraobserver variability.

Results: We found no significant interobserver variability on combined assessment of all operators with fair agreement in round 1 (Fleiss' kappa = 0.30, p <0.0001) and slight agreement in round 2 (Fleiss' kappa = 0.19, p < 0.0001). Cochran's Q test revealed no significant intraobserver variability in all 14 operators between round 1 and round 2 (all p>0.05).

Conclusions: We found no statistically significant inter- or intraobserver variability in the U-scoring of thyroid nodules between all participants reinforcing the validity of this scoring method in clinical practice, allaying concerns regarding potential subjective biases in reporting.

使用BTA u评分指南对甲状腺结节进行超声分级-是否有证据表明观察者内部和观察者之间存在差异?
U-score超声分级(分级为U1-U5)广泛应用于甲状腺结节的良恶性超声特征分级。众所周知,超声是一种依赖于操作人员的成像方式,因此在使用基于成像的评分系统时,操作员之间的主观差异更容易受到影响。我们的目的是评估在对甲状腺结节进行u评分时,是否存在任何观察者内部或观察者之间的可变性,以及以前的甲状腺超声经历是否对这种可变性有影响。方法:选取14名超声手术人员(5名有经验的甲状腺手术人员,5名有中级经验的手术人员,4名无经验的手术人员),对20例甲状腺患者的单投影图像进行u -评分,包括有无多普勒血流。6周后,14名手术人员将病例追回。然后使用Fleiss' kappa评估观察者之间的可变性和Cochran's Q测试来确定观察者内部的可变性,对三个操作员组的第一轮和第二轮u分数进行分析。结果:我们发现在第1轮对所有操作者的公平一致的综合评估中,观察者之间没有显著的差异(Fleiss’kappa = 0.30, pp p>0.05)。结论:我们发现,在所有参与者之间,甲状腺结节的u评分没有统计学意义上的差异,这加强了该评分方法在临床实践中的有效性,减轻了对报告中潜在主观偏差的担忧。
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来源期刊
Ultrasound
Ultrasound RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
1.70
自引率
0.00%
发文量
55
期刊介绍: Ultrasound is the official journal of the British Medical Ultrasound Society (BMUS), a multidisciplinary, charitable society comprising radiologists, obstetricians, sonographers, physicists and veterinarians amongst others.
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