This study aimed to describe a method of reducing interobserver variation associated with the visual quantitation of high-resolution computed tomographic (HRCT) signs of airways and interstitial lung disease (ILD).
The HRCT scans of 2 cohorts of patients with airways disease (n = 144) and ILD (n = 109) were evaluated by 2 observers. Selected signs of airways disease were evaluated: (1) bronchial wall thickness and (2) the extent of the decreased attenuation. In the ILD group, the total extent of disease was scored. These 3 HRCT signs were scored by 2 observers independently using a standard method. The observers rescored the CT scans with a new scoring system (continuous learning method, CLM).
Observer agreement for CT signs was superior for CLM: bronchial wall thickness κw increased from 0.51 to 0.76; for decreased attenuation, κw increased from 0.34 to 0.81; and for ILD extent, κw increased from 0.53 to 0.87.
The CLM reduces noise from observer variation in studies that require visual quantitation of HRCT signs of lung disease.
From the *Department of Clinical Sciences, Section of Diagnostic Imaging, Padiglione Barbieri, University Hospital of Parma, Parma, Italy; †Department of Radiology, St Georges Hospital; Departments of ‡Radiology, §Radiology, Kings College Hospital, and ∥Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK.
Received for publication April 22, 2011; accepted June 2, 2011.
Reprints: Nicola Sverzellati, MD, PhD, Department of Clinical Sciences, Section of Diagnostic Imaging, University of Parma, Padiglione Barbieri, University Hospital of Parma, V. Gramsci 14, 43100, Parma, Italy (e-mail: firstname.lastname@example.org).
There is no financial relationship to disclose.
The authors report no conflicts of interest.