Interobserver variability in the evaluation of primary graft dysfunction after lung transplantation: impact of radiological training and analysis of discordant cases.
Adolescent
Adult
Aged
Clinical Competence
/ statistics & numerical data
Female
Humans
Lung
/ diagnostic imaging
Lung Transplantation
Male
Middle Aged
Observer Variation
Primary Graft Dysfunction
/ diagnostic imaging
Radiography
/ methods
Radiologists
/ education
Reproducibility of Results
Retrospective Studies
Young Adult
Chest X-ray
Interobserver variability
Lung transplantation
Primary graft dysfunction
Journal
La Radiologia medica
ISSN: 1826-6983
Titre abrégé: Radiol Med
Pays: Italy
ID NLM: 0177625
Informations de publication
Date de publication:
Feb 2022
Feb 2022
Historique:
received:
10
08
2021
accepted:
24
11
2021
pubmed:
15
12
2021
medline:
22
2
2022
entrez:
14
12
2021
Statut:
ppublish
Résumé
Radiologic criteria for the diagnosis of primary graft dysfunction (PGD) after lung transplantation are nonspecific and can lead to misinterpretation. The primary aim of our study was to assess the interobserver agreement in the evaluation of chest X-rays (CXRs) for PGD diagnosis and to establish whether a specific training could have an impact on concordance rates. Secondary aim was to analyze causes of interobserver discordances. We retrospectively enrolled 164 patients who received bilateral lung transplantation at our institution, between February 2013 and December 2019. Three radiologists independently reviewed postoperative CXRs and classified them as suggestive or not for PGD. Two of the Raters performed a specific training before the beginning of the study. A senior thoracic radiologist subsequently analyzed all discordant cases among the Raters with the best agreement. Statistical analysis to calculate interobserver variability was percent agreement, Cohen's kappa and intraclass correlation coefficient. A total of 473 CXRs were evaluated. A very high concordance among the two trained Raters, 1 and 2, was found (K = 0.90, ICC = 0.90), while a poorer agreement was found in the other two pairings (Raters 1 and 3: K = 0.34, ICC = 0.40; Raters 2 and 3: K = 0.35, ICC = 0.40). The main cause of disagreement (52.4% of discordant cases) between Raters 1 and 2 was the overestimation of peribronchial thickening in the absence of unequivocal bilateral lung opacities or the incorrect assessment of unilateral alterations. To properly identify PGD, it is recommended for radiologists to receive an adequate specific training.
Identifiants
pubmed: 34905128
doi: 10.1007/s11547-021-01438-5
pii: 10.1007/s11547-021-01438-5
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
145-153Informations de copyright
© 2021. Italian Society of Medical Radiology.
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