INTEROBSERVER VARIATION IN DUPLEX SONOGRAPHIC SCANNING IN THE FEMOROPOPLITEAL TRACT

The diagnostic value of duplex sonographic scanning was demonstrated i n a number of studies, but there is lack of consensus on which charact eristic of the Doppler spectrum correlates best with the severity of p eripheral vascular disease. Ln a prospective study we quantified the i nterobserver variation in duplex scanning for the diagnosis of periphe ral vascular disease. Forty-one patients with intermittent claudicatio n were independently examined by two observers. The observers were una ware of the angiographic findings. Reproducibility of classification a nd separate characteristics of the Doppler spectrum were expressed as kappa coefficients, Pearson correlation coefficients, and repeatabilit y coefficients. PSV was the most reproducible characteristic of the Do ppler spectrum. The classification of peripheral disease in 0 to 19%, 20 to 49%, 50 to 99%, and 100% diameter reduction was highly reproduci ble (kappa 0.68). The other characteristics of the Doppler spectrum we re moderately to poorly reproducible; wave form contour, spectral broa dening, and end diastolic velocity had kappa values of 0.56, 0.20, and 0.56, respectively. Our findings justify a simplification of the crit eria for duplex sonographic scanning for diagnosis of peripheral vascu lar disease.