Soft-copy versus hard-copy interpretation of voiding cystourethrography inneonates, infants, and children

OBJECTIVE. Our aim is to determine whether agreement occurs between soft-co py (at a review workstation) and hard-copy ton laser-printed film) interpre tations of fluoroscopic voiding cystourethrograms in neonates, infants, and children, SUBJECTS AND METHODS, Voiding cystourethrography was performed on 74 childr en (range, 2 weeks to 11 years old; mean, 3 years 6 months) for the evaluat ion of vesicoureteral reflux. The right and left ureters were scored separa tely by two observers on a scale of 0-5 using the international grading sta ndard. Differences were tested for statistical significance with a marginal homogeneity test, and the strength of agreement was assessed using the kap pa statistic. RESULTS. Of the 148 ureters evaluated, 39 showed vesicoureteral reflux and 109 showed no vesicoureteral reflux on both soft copy and hard copy. For 12 8 of 148 evaluations, interpretations of soft copy and hard copy produced a greement as to the grade of vesicoureteral reflux. For 11 of the 30 ureters with divergent interpretations, hard copy was scored one grade lower than soft copy; for the remaining nine ureters, hard copy was scored one grade h igher than soft copy. No score differed by more than one grade. We found no statistically significant difference between soft-copy and hard-copy score s (p =.65), and agreement using the kappa statistic was substantial(.68), CONCLUSION. Soft-copy interpretation of voiding cystourethrograms is simila r to hard-copy interpretation for vesicoureteral reflux.