Variabilities in Reference Standard by Radiologists and Performance Assessment in Detection of Pulmonary Embolism in CT Pulmonary Angiography.

Annotating lesion locations by radiologists' manual marking is a key step to provide reference standard for the training and testing of a computer-aided detection system by supervised machine learning. Inter-reader variability is not uncommon in readings even by expert radiologists. This study evalu...

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Publicado en:Journal of Digital Imaging Vol. 32; no. 6; pp. 1089 - 1097
Autores principales: Zhou, Chuan, Chan, Heang-Ping, Chughtai, Aamer, Patel, Smita, Kuriakose, Jean, Hadjiiski, Lubomir M., Wei, Jun, Kazerooni, Ella A.
Formato: diagnostic images pictorial research tables/charts Journal Article
Publicado: Springer Nature Dec2019
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Springer Nature
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        atl: Variabilities in Reference Standard by Radiologists and Performance Assessment in Detection of Pulmonary Embolism in CT Pulmonary Angiography.
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        au:
          Zhou, Chuan
          Chan, Heang-Ping
          Chughtai, Aamer
          Patel, Smita
          Kuriakose, Jean
          Hadjiiski, Lubomir M.
          Wei, Jun
          Kazerooni, Ella A.
        affil: Department of Radiology, University of Michigan, 1500 E. Medical Center Drive, 48109, Ann Arbor, MI, USA
      sug:
        subj:
          Pulmonary Embolism Diagnosis
          Diagnosis, Computer Assisted
          Computed Tomography Angiography
          Clinical Competence Evaluation
          Radiologists Psychosocial Factors
          Human
          Machine Learning
          Consensus
          Weights and Measures
          Interrater Reliability
      ab: Annotating lesion locations by radiologists' manual marking is a key step to provide reference standard for the training and testing of a computer-aided detection system by supervised machine learning. Inter-reader variability is not uncommon in readings even by expert radiologists. This study evaluated the variability of the radiologist-identified pulmonary emboli (PEs) to demonstrate the importance of improving the reliability of the reference standard by a multi-step process for performance evaluation. In an initial reading of 40 CTPA PE cases, two experienced thoracic radiologists independently marked the PE locations. For markings from the two radiologists that did not agree, each radiologist re-read the cases independently to assess the discordant markings. Finally, for markings that still disagreed after the second reading, the two radiologists read together to reach a consensus. The variability of radiologists was evaluated by analyzing the agreement between two radiologists. For the 40 cases, 475 and 514 PEs were identified by radiologists R1 and R2 in the initial independent readings, respectively. For a total of 545 marks by the two radiologists, 81.5% (444/545) of the marks agreed but 101 marks in 36 cases differed. After consensus, 65 (64.4%) and 36 (35.6%) of the 101 marks were determined to be true PEs and false positives (FPs), respectively. Of these, 48 and 17 were false negatives (FNs) and 14 and 22 were FPs by R1 and R2, respectively. Our study demonstrated that there is substantial variability in reference standards provided by radiologists, which impacts the performance assessment of a lesion detection system. Combination of multiple radiologists' readings and consensus is needed to improve the reliability of a reference standard.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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