RATER AGREEMENT IN LUNG SCINTIGRAPHY

Purpose: The PIOPED criteria in their original and revised forms are t oday's standards in the interpretation of ventilation-perfusion scinti graphy. When the PIOPED criteria are used by experienced raters with t raining in consensus interpretation, the agreement rates have been dem onstrated to be excellent. Our purpose was to investigate the rates of agreement between 2 experienced raters from different hospitals who h ad no training in consensus interpretation. Material and Methods: The 2 raters investigated a population of 195 patients. This group include d 72 patients from a previous study who had an intermediate probabilit y of pulmonary embolism and who had also been examined by pulmonary an giography. Results: The results demonstrated moderate agreement rates with a kappa value of 0.54 (0.45-0.63 in a 95% confidence interval), w hich is similar to the kappa value of the PIOPED study but significant ly lower than the kappa values of agreement rates among consensus-trai ned raters. There was a low consistency in the intermediate probabilit y category, with a proportional agreement rate of 0.39 between the exp erienced raters. Conclusion: The moderate agreement rates between rate rs from different hospitals make it difficult to compare study populat ions of a certain scintigraphic category in different hospitals. Furth er investigations are mandatory for accurate diagnosis when the scinti grams are in the category of intermediate probability of pulmonary emb olism.