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Radiologist variability in assessing the position of the cavoatrial junction on chest radiographs

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Abstract

OBJECTIVE: To assess the variability in identifying the cavoatrial junction (CAJ) on chest X-rays (CXRs) amongst radiologists. METHODS: 23 radiologists (13 consultants and 10 trainees) assessed 25 posteroanterior erect CXRs (including 8 duplicates) and marked the positions of the CAJ. Differences in the CAJ position both within and between observers were evaluated and reported as limits of agreement (LOA), repeatability coefficients (RCs) and intraclass correlation coefficients and were displayed graphically with Bland–Altman plots. RESULTS: The mean difference for within-observer assessments was -0.2?cm (95% LOA, -1.5 to +1.1?cm) and between observers, it was -0.3?cm (95% LOA, -2.5 to +1.8?cm). Intraobserver RCs were marginally lower for consultants than for trainees (1.1 vs 1.5). RCs between observers were comparable (2.1 vs 2.2) for consultants and trainees, respectively. CONCLUSION: This study detected a large interobserver variability of the CAJ position (up to 4.3?cm). This is a significant finding considering that the length of the superior vena cava is reported to be approximately 7?cm. We conclude that there is poor consensus regarding the CAJ position amongst radiologists. ADVANCES IN KNOWLEDGE: No comparisons exist between radiologists in determining CAJ position from CXRs. This report provides evidence of the large observer variability amongst radiologists and adds to the discussion regarding the use of CXRs in validating catheter tip location systems.

Citation

(2016). Radiologist variability in assessing the position of the cavoatrial junction on chest radiographs. British Journal of Radiology, 20150965 - 20150965. https://doi.org/10.1259/bjr.20150965

Acceptance Date Jul 11, 2016
Publication Date Jul 29, 2016
Journal The British Journal of Radiology
Print ISSN 0007-1285
Publisher British Institute of Radiology
Pages 20150965 - 20150965
DOI https://doi.org/10.1259/bjr.20150965
Publisher URL https://www.birpublications.org/doi/pdf/10.1259/bjr.20150965

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