Methods Inf Med - Measuring inter-observer agreement in contour delineation of medical imaging in a dummy run using Fleiss' kappa.

Tópicos

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Resumo

CKGROUND: In medical imaging used for planning of radiation therapy, observers delineate contours of a treatment volume in a series of images of uniform slice thickness.OBJECTIVE: To summarize agreement in contouring between an arbitrary number of observers by a single number, we generalized the kappa index proposed by Zijdenbos et al. (1994).METHODS: Observers characterized voxels by allocating them to one of two categories, inside or outside the contoured region. Fleiss' kappa was used to measure association between n indistinguishable observers. Given the number Vi of voxels contoured by exactly i observers (i = 1, ..., n ), the resulting overall kappa is representable as a ratio of weighted sums of the Vi .RESULTS: Overall kappa was applied to analyze inter-center variations in a multicenter trial on radiotherapy planning in patients with locally advanced lung cancer. A contouring dummy run was performed within the quality assurance program. Contouring was done twice, once before and once after a training program. Observer agreement was enhanced from 0.59 (with a 95% confidence interval (CI) of 0.51-0.67) to 0.69 (95% CI 0.59-0.78).CONCLUSION: By contrast to average pairwise indices, overall kappa measures observer agreement for more than two observers using the full information about overlapping volumes, while not distinguishing between observers. It is particularly adequate for measuring observer agreement when identification of observers is not possible or desirable and when there is no gold standard.

Resumo Limpo

ckground medic imag use plan radiat therapi observ delin contour treatment volum seri imag uniform slice thicknessobject summar agreement contour arbitrari number observ singl number general kappa index propos zijdenbo et al method observ character voxel alloc one two categori insid outsid contour region fleiss kappa use measur associ n indistinguish observ given number vi voxel contour exact observ n result overal kappa represent ratio weight sum vi result overal kappa appli analyz intercent variat multicent trial radiotherapi plan patient local advanc lung cancer contour dummi run perform within qualiti assur program contour done twice train program observ agreement enhanc confid interv ci ci conclus contrast averag pairwis indic overal kappa measur observ agreement two observ use full inform overlap volum distinguish observ particular adequ measur observ agreement identif observ possibl desir gold standard

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