Obuchowski N A, Zepp R C
Department of Biostatistics and Epidemiology, The Cleveland Clinic Foundation, OH 44195-5196, USA.
AJR Am J Roentgenol. 1996 Mar;166(3):517-21. doi: 10.2214/ajr.166.3.8623619.
Multiple-reader study designs have become popular in the radiology literature. We reviewed the major papers published in the American Journal of Roentgenology in the first 4 months of each of the years 1990 and 1995. The review was restricted to prospective studies of image interpretation. In the 1990 literature, we noted eight multiple-reader and 18 single-reader studies; in contrast, in the 1995 literature, we found 29 multiple-reader and eight single-reader studies. This trend reflects an increased awareness of the importance of multiple-reader studies. We examined the Results sections of the 29 multiple-reader studies from 1995 to assess the authors' motives for incorporating such a design. In 16 studies (55%), readers independently interpreted all images. However, the authors usually reported only the average interpretation of the readers; in only seven of the 29 studies (24%) did the authors describe differences among readers' interpretations. In 13 studies, interpretations were performed exclusively through "consensus reading." The method(s) used to achieve a consensus often were not explained. Only two of the 29 studies had more than three readers. In contrast, all of these studies included multiple patients. The average patient sample size was 45. Furthermore, differences observed among patients were routinely reported and/or depicted.
多读者研究设计在放射学文献中已变得很普遍。我们回顾了1990年和1995年每年前4个月发表在美国《放射学杂志》上的主要论文。此次回顾仅限于影像解读的前瞻性研究。在1990年的文献中，我们注意到有8项多读者研究和18项单读者研究；相比之下，在1995年的文献中，我们发现有29项多读者研究和8项单读者研究。这一趋势反映出对多读者研究重要性的认识有所提高。我们检查了1995年29项多读者研究的结果部分，以评估作者采用这种设计的动机。在16项研究（55%）中，读者独立解读所有影像。然而，作者通常仅报告读者的平均解读结果；在29项研究中只有7项（24%）作者描述了读者解读结果之间的差异。在13项研究中，解读完全通过“共识阅读”进行。用于达成共识的方法通常未作解释。29项研究中只有两项的读者超过3人。相比之下，所有这些研究都纳入了多名患者。患者样本的平均规模为45。此外，患者之间观察到的差异都有常规报告和/或描述。
