[The degree of agreement in the radiological interpretation of the growth of left cardiac cavities between the radiologist, the family physician and residents in family and community medicine].

OBJECTIVE

To discover the level of agreement about the radiological interpretation of the growth of left-side cardiac cavities, between the referring radiologist (Rx), a family doctor (FD) and three interns studying the third year of family and community medicine (IFCM).

DESIGN

Observational crossover study.

SETTING

Primary Care (PC). The Perpetuo Socorro Health Centre in Huesca.

PATIENTS AND OTHER PARTICIPANTS

Hypertense patients included in the programme of one of the general medicine sections.

MEASUREMENTS AND MAIN RESULTS

There were 69 thorax radiographies (TXR), 10 of which were repeated in order to assess the level of agreement between different evaluations by the same observer (intra-observer). Out of these 69, there was agreement between observers in 39 cases (66.10%) with Kappa Index (KI) 0.39 +/- 0.12 for two IFCMs (2 and 3); in 44 (74.57%), with KI 0.55 +/- 0.12 for the first IFCM; and in 40 (67.10%), with KI 0.39 +/- 0.12 for the FD. The intra-observer agreement was 80% with KI 0.50 +/- 0.29, 60% with KI 0.20 +/- 0.23 and 90% with KI 0.80 +/- 0.23 for the three IFCM's. It was 70% with KI 0.34 +/- 0.27 for the FD and 80% with KI 0.48 +/- 0.29 for the Rx.

CONCLUSIONS

Both the inter- and intra-observer agreement levels were insufficient. We propose that our training during the period of specialisation should be strengthened on the most useful questions from the PC point of view. Studies of this sort need to be carried out in PC in order to obtain maximum benefit from these complementary tests.