Circulation, Vol 64, 601-609, Copyright © 1981 by American Heart Association
JE Atwood, D Jensen, V Froelicher, K Witztum, K Gerber, E Gilpin and W Ashburn
To assess the agreement of human interpretation of analog thallium
myocardial perfusion images, four experienced interpreters evaluated 100
images on two occasions using a form designed to limit reader variability.
A high intraobserver agreement (agreement by same observer at separate
times) of 89--93% was found when films were interpreted as normal or
abnormal (a dichotomous decision). Interobserver agreement for a majority
grouping of observers (three or four) was 75% for an abnormal and 68% for a
normal interpretation. However, agreement ranged from 11--79% when
interpreters were asked to read the anatomic location of defects. Posterior
and lateral wall defects were interpreted with the least amount of
agreement. These results indicate that caution must be taken when
interpreting defect location. Using a scale of 1--10 to grade the severity
of a defect, correlations of 0.82--0.86 were found when reading defects in
the lateral and anterior projections. Higher correlations, from 0.86--0.94,
were found in left anterior oblique views. Use of reporting forms with
specific criteria, multiple observers at one occasion, and/or computer
processing may improve agreement. A brief review of the agreement of
cardiology testing procedures is also presented.
ARTICLES
Agreement in human interpretation of analog thallium myocardial perfusion images
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