Division of General Internal Medicine, Department of Medicine, Toronto General Hospital, Toronto, ON, M2G 2C4, Canada.
Vasc Health Risk Manag. 2024 Aug 13;20:359-368. doi: 10.2147/VHRM.S431612. eCollection 2024.
The reliability of interpretation of coronary angiography as a diagnostic tool was investigated. Furthermore, the impact of interobserver variability of coronary lesions on clinical decision-making was assessed. One of our motivations to do this research was the research gaps and our aim to have up-to-date information regarding interobserver variability among different cardiologists.
Our objective was to quantify interobserver variability among cardiologists who have seen angiograms independently. Disagreement among cardiologists in the visual assessment of invasive coronary angiography of coronary artery stenosis is not uncommon in previous studies. Three cardiologists with extensive experience in coronary angiography, including the primary cardiologist of each patient, read the angiograms of 200 patients from Toronto General Hospital independently.
Our research showed the mean agreement among all participating observers was 77.4%; therefore, the interobserver variability of coronary angiography interpretation was 22.6%.
Coronary angiography is still the gold-standard technique for guidance regarding coronary lesions. Sometimes, coronary angiography results in underestimation or overestimation of a lesion's functional severity. Interobserver variability should also be considered when interpreting the severity of coronary stenoses via invasive coronary angiography. This research shows that interobserver variability regarding coronary angiograms is still present (22.6%).
本研究旨在调查冠状动脉造影作为诊断工具的解读可靠性,并评估冠状动脉病变的观察者间变异性对临床决策的影响。我们开展此项研究的动机之一是为了填补研究空白,并希望获得关于不同心脏病专家之间观察者间变异性的最新信息。
我们的目的是量化独立阅片的心脏病专家之间的观察者间变异性。在之前的研究中,不同心脏病专家在对冠状动脉狭窄的侵入性冠状动脉造影的视觉评估中存在分歧并不罕见。三位在冠状动脉造影方面经验丰富的心脏病专家(包括每位患者的主要心脏病专家)独立阅读了来自多伦多总医院的 200 名患者的冠状动脉造影图像。
我们的研究表明,所有参与观察者的平均一致性为 77.4%;因此,冠状动脉造影解读的观察者间变异性为 22.6%。
冠状动脉造影仍然是指导冠状动脉病变的金标准技术。有时,冠状动脉造影会导致病变功能严重程度的低估或高估。在通过侵入性冠状动脉造影来解读冠状动脉狭窄的严重程度时,也应考虑观察者间变异性。本研究表明,冠状动脉造影的观察者间变异性仍然存在(22.6%)。