Sushentsev Nikita, Bura Vlad, Kotnik Maruša, Shiryaev Grigoriy, Caglic Iztok, Weir-McCall Jonathan, Barrett Tristan
Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Cambridge, United Kingdom.
Department of Radiology, County Clinical Emergency Hospital, Cluj-Napoca, Romania.
BJR Open. 2020 Dec 11;2(1):20200053. doi: 10.1259/bjro.20200053. eCollection 2020.
To evaluate the inter- and intraobserver agreement of COVID-RADS and CO-RADS reporting systems among differently experienced radiologists in a population with high estimated prevalence of COVID-19.
Chest CT scans of patients with clinically-epidemiologically diagnosed COVID-19 were retrieved from an open-source MosMedData data set, randomised, and independently assigned COVID-RADS and CO-RADS grades by an abdominal radiology fellow, thoracic imaging fellow and a consultant cardiothoracic radiologist. The inter- and intraobserver agreement of the two systems were assessed using the Fleiss' and Cohen's κ coefficients, respectively.
A total of 200 studies were included in the analysis. Both systems demonstrated moderate interobserver agreement, with κ values of 0.51 [95% confidence interval (CI): 0.46-0.56] and 0.55 (95% CI: 0.50-0.59) for COVID-RADS and CO-RADS, respectively. When COVID-RADS and CO-RADS grades were dichotomised at cut-off values of 2B and 4 to evaluate the agreement between grades representing different levels of clinical suspicion for COVID-19, the interobserver agreement became substantial with κ values of 0.74 (95% CI: 0.66-0.82) for COVID-RADS and 0.73 (95% CI: 0.65-0.81) for CO-RADS. The median intraobserver agreement was considerably higher for CO-RADS reaching 0.81 (95% CI: 0.43-0.76) compared with 0.60 (95% CI: 0.43-0.76) of COVID-RADS.
COVID-RADS and CO-RADS showed comparable interobserver agreement, which was moderate when grades were compared head-to-head and substantial when grades were dichotomised to better reflect the underlying levels of suspicion for COVID-19. The median intraobserver agreement of CO-RADS was, however, considerably higher compared with COVID-RADS.
This paper provides a comprehensive review of the newly introduced COVID-19 chest CT reporting systems, which will help radiologists of all sub-specialties and experience levels make an informed decision on which system to use in their own practice.
在估计新冠病毒病（COVID-19）患病率较高的人群中，评估不同经验水平的放射科医生对COVID-RADS和CO-RADS报告系统的观察者间及观察者内一致性。
从开源的MosMedData数据集中检索临床流行病学诊断为COVID-19患者的胸部CT扫描图像，进行随机分组，并由一名腹部放射科住院医师、一名胸部影像住院医师和一名心胸放射科顾问医生独立给出COVID-RADS和CO-RADS分级。分别使用Fleiss κ系数和Cohen κ系数评估两个系统的观察者间及观察者内一致性。
共200项研究纳入分析。两个系统均显示出中等程度的观察者间一致性，COVID-RADS和CO-RADS的κ值分别为0.51[95%置信区间（CI）：0.46 - 0.56]和0.55（95% CI：0.50 - 0.59）。当将COVID-RADS和CO-RADS分级在2B和4的临界值处进行二分法划分，以评估代表不同COVID-19临床怀疑程度的分级之间的一致性时，观察者间一致性变得很高，COVID-RADS的κ值为0.74（95% CI：0.66 - 0.82），CO-RADS的κ值为0.73（95% CI：0.65 - 0.81）。CO-RADS的观察者内一致性中位数显著高于COVID-RADS，分别为0.81（95% CI：0.43 - 0.76）和0.60（95% CI：0.43 - 0.76）。
COVID-RADS和CO-RADS显示出相当的观察者间一致性，直接比较分级时为中等程度，二分法划分分级以更好地反映对COVID-19的潜在怀疑程度时为高度一致。然而，CO-RADS的观察者内一致性中位数显著高于COVID-RADS。
本文对新引入的COVID-19胸部CT报告系统进行了全面综述，这将有助于所有亚专业和经验水平的放射科医生就是否使用该系统做出明智的决策。
