J Korean Radiol Soc. 2004 Sep;51(3):351-356. Korean.
Published online Sep 30, 2004.
Copyright © 2004 by The Korean Society of Radiology
Original Article

Interobserver Variability in Interpretation of Mammogram

Kyung Jae Lee, Won Chul Lee, In Young Hwang, Mi Hye Kim, Hak Hee Kim, Young Gyu Park, Hae Kyung Lee, Sang Seol Jung and Hoon Kyo Kim1
    • Department of Preventive Medicine, Soonchunhyang University College of Medicine, Korea.
    • Department of Preventive Medicine, the Catholic University of Korea College of Medicine, Korea.
    • Kim Mi Hye Breast Clinic, Korea.
    • Department of Radiology, Ulsan University College of Medicine, Korea.
    • Department of Biostatistics, the Catholic University of Korea, Korea.
    • Department of Radiology, Soonchunhyang University College of Medicine, Korea.
    • Department of General Surgery, the Catholic University of Korea, Korea.
    • Department of Internal Medicine, the Catholic University of Korea, Korea.

Abstract

Purpose

The purpose of this study was to evaluate the performance of radiologists for mammographic screening, and to analyze interobserver agreement in the interpretation of mammograms.

Materials and Methods

50 women were selected as subjects from the patients who were screened with mammograms at two university hospitals. The images were analyzed by five radiologists working independently and without their having any knowledge of the final diagnosis. The interobserver variation was analyzed by using the kappa statistic.

Results

There were moderate agreements for the findings of the parenchymal pattern (k=0.44; 95% CI 0.39-0.49), calcification type (k=0.66; 95% CI 0.60-0.72) and calcification distribution (k=0.43; 95% CI 0.38-0.48). The mean kappa values ranged from 0.66 to 0.42 for the mass findings. The mean kappa value for the final conclusion was 0.44 (95% CI 0.38-0.51). In general, moderate agreement was evident for all the categories that were evaluated.

Conclusion

The general agreement was moderate, but there was wide variability in some findings. To improve the accuracy and reduce variability among physicians in interpretation, proper training of radiologists and standardization of criteria are essential for breast screening.

Keywords
Interobserver variability; Mammography; Kappa value


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