Circulation, Vol 52, 979-986, Copyright © 1975 by American Heart Association
KM Detre, E Wright, ML Murphy and T Takaro
The reliability of interpretation of coronary arteriography as a diagnostic
tool was investigated in a sub-study of the VA Cooperative Study of
Surgical Treatment for Coronary Arterial Occlusive Disease. Twenty-two
physicians with varying levels of experience read 13 cine angiograms --
blind -- on two different occasions. Analysis of inter- and intraobserver
variability showed that angiographic items about which observers were most
inconsistent from one reading to the other had the largest interobserver
disagreement as well. They were the distal portions of the left anterior
descending and left circumflex arteries. Among the items on which there was
most consistent agreement - - namely, the right main coronary artery and
presence of ventricular aneurysm -- there was most often agreement between
observers as well. When individual readers were evaluated, some observers
were far more consistent in their own readings of all the angiographic
items than others. This intraobserver agreement in turn correlated fairly
well with how often they agreed with the other observers and with how much
experience they reported having in reading coronary cineangiograms.
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