Circulation, Vol 55, 324-328, Copyright © 1977 by American Heart Association
TA DeRouen, JA Murray and W Owen
Variability in coronary arteriogram readings was studied by having cine
films from ten patients read by eleven readers. Three of the eleven
subsequently met as an expert panel to provide a joint evaluation which
could serve as a standard. Considerable variability was found between
individual readers and between readers and the panel. The average standard
deviation for estimation of any segmental stenosis by any single reader was
18%. Disagreement about the number of major vessels with a 70% stenosis
occurred 31% of the time. Discrepancies were most likely to occur in
analyzing distal arterial segments, in reading nonopacified segments, and
during analysis of films showing more severe disease or having poorer
technical quality. Recent experience in reading arteriograms seemed to be
the most important characteristic in determining the accuracy of a reader.
A protocol for the use of three readers is suggested.
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Variability in the analysis of coronary arteriograms
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