Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul 137-701, Korea.
Korean J Radiol. 2010 Mar-Apr;11(2):149-55. doi: 10.3348/kjr.2010.11.2.149. Epub 2010 Feb 22.
To evaluate the interobserver variability and performance in the interpretation of ultrasonographic (US) findings of thyroid nodules.
72 malignant nodules and 61 benign nodules were enrolled as part of this study. Five faculty radiologists and four residents independently performed a retrospective analysis of the US images. The observers received one training session after the first interpretation and then performed a secondary interpretation. Agreement was analyzed by Cohen's kappa statistic. Degree of performance was analyzed using receiver operating characteristic (ROC) curves.
Agreement between the faculties was fair-to-good for all criteria; however, between residents, agreement was poor-to-fair. The area under the ROC curves was 0.72, 0.62, and 0.60 for the faculties, senior residents, and junior residents, respectively. There was a significant difference in performance between the faculties and the residents (p < 0.05). There was a significant increase in the agreement for some criteria in the faculties and the senior residents after the training session, but no significant increase in the junior residents.
Independent reporting of thyroid US performed by residents is undesirable. A continuous and specialized resident training is essential to enhance the degree of agreement and performance.
评估甲状腺结节超声（US）表现的观察者间变异性和表现。
本研究纳入 72 个恶性结节和 61 个良性结节。5 位教授放射科医生和 4 位住院医生独立对 US 图像进行回顾性分析。观察者在第一次解释后接受一次培训，然后进行二次解释。采用 Cohen's kappa 统计分析一致性。使用受试者工作特征（ROC）曲线分析性能程度。
对于所有标准，教授之间的一致性为中等到良好；然而，住院医生之间的一致性为差到中。ROC 曲线下面积分别为 0.72、0.62 和 0.60，适用于教授、高级住院医生和初级住院医生。教授和住院医生之间的表现存在显著差异（p < 0.05）。教授和高级住院医生在培训后，一些标准的一致性显著增加，但初级住院医生没有显著增加。
不建议由住院医生独立报告甲状腺 US。需要持续和专门的住院医生培训，以提高一致性和性能程度。
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