Variability in the interpretation of thorax radiography in a primary care medical community and its reference radiologists
Simó Miñana, J.; Riquelme Miralles, D.A.
Atencion Primaria 21(9): 599-606
1998
ISSN/ISBN: 0212-6567 PMID: 9677743 Document Number: 491276
To know the variability in the interpretation (normal/pathological) of posteroanterior view chest radiograph and the associated factors between a medical primary care community and a Gold Standard (GS) from 3 reference radiologists. Crossover study. Primary care. Teaching health centers of Elche. Interobserver percentage agreement (IPA) and Kappa statistic (K) were used to analyse the interobserver agreement (IA) between the GS and every of the participants in interpretation of 100 radiographs. Intraobserver variability was assessed with a second review. Using uni and multivariant analysis some possibly associated factors were studied. Overall IPA and K were 71.3% (CI 95%: 69.2-73.3) and 0.41 (CI 95%: 0.36-0.46) respectively. Time employed in radiographs reading and time passed after medicine studies finished were independently and significantly associated to higher and lower interobserver agreement results respectively, whereas recent professional experience, permanent job and age were not associated. Professional training is the variable that most explain the inter and intraobserver variability. Overall IA is acceptable. The IA showed by the participants trained under the MIR system is good but the IA achieved by the rest of participants is not acceptable. It is necessary a training which increase the clinical competence, as it does MIR training.