Abstract
Inter and intea-observer agreement in classifying the presence of gallstones by ultrasonographic images according to established criteria was studied. A film recording of 50 routine ultrasonographic examinations of the gallbladder was read by each of the 46 observers who participated in the Multicenter Italian Study on Epidemiology of Cholelithiasis (M.I.COL.). The overall Kappa score for inter-observer agreement was 0.649, while intea-observer agreement was “good” or “excellent” (Kappa scores >0.60) in 75% of the observers. No statistical difference for inter-observer agreement between “novices” and “expert” echographers was found in the overall Kappa statistic or in category-specific Kappa scores (gallstone, no gallstone, doubtful and inconclusive examinations) The present study suggests that the development of explicit criteria by a group of trained echographers does not eliminate inter-and intea-observer disagreement in categorizing subjects for gallbladder stones.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
AchesonR.M. (1960): Observer error and variation in the interpretation of electrocardiograms in an epedemiological study of coronary heart disease. -Br. J. Prev. Soc. Med., 14: 99–122.
Allen-MershT.G., MotsonR.W., HatelyW. (1985): Does it matter who does ultrasound examination of the gallbladder? - Br. Med. J., 291: 389–390.
BarbaraL., SamaC., Morselli LabateA., et al. (1987): A population study on the prevalence of gallstone disease: the Sirmione study. - Hepatology, 7: 913–917.
BirnholzJ.C. (1982): Population survey: ultrasonic cholecistography. - Gastrointest. Radiol. 7: 165–167.
ConnH.O., SmithH.W., BrodoG.G.H.M. (1965): Observer variation in the endoscopic diagnosis of esophageal varices: a prospective investigation of the diagnostic validity of esophagoscopy. - N. Engl. J. Med. 272: 830–834.
CooperbergP.L., BurhenneH.J. (1980): Realtime ultrasonography: diagnostic technique of choice in calculous gallbladder disease. - N. Engl. J. Med. 302: 1277–1279.
CradeM., TaylorK.J., RosenfreldA.T.et al. (1978): Surgical and pathological correlation of cholecystosonography and cholecistography. - Am. J. Roentg. 131: 227–229.
FerrucciJ.T., FondtracinJ.S., CooperbergP.L., WeismanH.S. (1981): The radiologic diagnosis of gallbladder disease: an imaging symposium.- Radiology 141: 149–156.
FleissJ.L. (1981): Statistical methods for rates and proportions, 2nd ed. Wiley, New York.
GeffenH., DarnboroughA., DeDombalF.T.et al. (1968): Radiological signs of ulcerative colitis: assessment of their reliability by means of observer variation study. - Gut 9: 150–158.
GiørupT., BrahmM., FoghJ.et al. (1986): Interobserver variation in the detection of metastases on liver scans. - Gastroenterology 90: 166–172.
GoodL.I., EdellS.L., SolowayR.D.et al. (1979): Ultrasonic properties of gallstones. Effect of stone size and composition. - Gastroenterology, 77: 258–263.
KoranL.M. (1975): The reliability of clinical methods, data and judgments. - N. Engl. J. Med. 293: 642–646 (1st part); 695–701 (2nd part).
IngefingerF.J. (1968): Digestive disease as a national problem. - V. Gallstones. Gastroenterology, 55: 102–104.
LandisJ.R., KochG.G. (1977): The measurement of observer agreement for categorical data. -Biometrics, 33: 159–174.
Lee HessM., CunninghamJ.J. (1984): Effect of examination time of day on the quality of real-time cholesonograms. - Am. J. Roentg 143: 251–253.
McIntoshD.M.F., PenneyH.F. (1980): Gray-scale ultrasonography as a screening procedure in the detection of gallbladder disease. - Radiology 136: 725–727.
NishiyamaH., LewisJ.T., AshareA.B., SaengerE.L. (1975): Interpretation of radionuclide liver images: do training and experience make a difference? - J. Nucl. Med., 16: 11–16.
RabinowitzJ.G., YehH.C., CohenB.A. (1983): Gallstone update: radiology. - Semin Liver Dis. 3: 120–131.
RafteryE.B., HollandW.W. (1967): Examination of the heart: and investigation into variation. - Am. J. Epidemiol., 85: 438–444.
Rome Group for the epidemiology and prevention of cholelitiasis (GREPCO) (1984): Prevalence of gallstone disease in an italian adult female population. - Am. J. Epidemiol. 118: 796–805.
Author information
Authors and Affiliations
Consortia
Additional information
M.I.COL. (Multicentrica Italiana Colelitiasi).
Corresponding author.
See appendix.
Rights and permissions
About this article
Cite this article
Festi, D., Lalloni, L., Taroni, F. et al. Inter and intea-observer variation in ultrasonographic detection of gallstones: The Multicenter Italian Study on Epidemiology of Cholelithiasis (M.I.COL.). Eur J Epidemiol 5, 51–57 (1989). https://doi.org/10.1007/BF00145045
Issue Date:
DOI: https://doi.org/10.1007/BF00145045