Reproducibility of a scoring system for computed tomography scanning in cystic fibrosis

Journal of Thoracic Imaging
Alan S BrodyPhilip M Farrell

Abstract

Computerized tomography (CT) scanning shows promise as an outcome surrogate for cystic fibrosis (CF) lung disease progression. The scoring system used to convert the CT image to numeric data is an essential determinant of the performance of CT scanning. Three radiologists independently scored 16 high-resolution CT scans performed on children in the Wisconsin CF Neonatal Screening Project. The test scans were selected to provide a broad range of disease severity. The scoring system provided subscores for the presence and severity of 5 findings of CF lung disease. The sum of the subscores provided a total score. The CT scans were then read again by each of the radiologists at least 11 months later. Using Mixed Effects Linear Model Analysis, the sources of error (scan-to-scan variation, interrater variance, and intrarater variance) were calculated. For the total score, the scan-to-scan variation was 14.48, interrater variance was 0.28, and intrarater variance was 0.45, with an overall reproducibility of 95%. The square root of scan-to-scan variance, a measure of sensitivity, was 3.81. Evaluation of the subscores showed higher reproducibility for bronchiectasis and hyperinflation (95% and 88%, respectively). The bronchiectasis scor...Continue Reading

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Citations

Jun 23, 2011·American Journal of Respiratory and Critical Care Medicine·Stephen M Stick, Peter David Sly
Jul 9, 2011·American Journal of Respiratory and Critical Care Medicine·Don B SandersPhilip M Farrell
Oct 4, 2011·American Journal of Respiratory and Critical Care Medicine·Cori Daines, Wayne Morgan
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