J Korean Radiol Soc.  2004 Sep;51(3):351-356. 10.3348/jkrs.2004.51.3.351.

Interobserver Variability in Interpretation of Mammogram

Affiliations
  • 1Department of Preventive Medicine, Soonchunhyang University College of Medicine, Korea. leewc@catholic.ac.kr
  • 2Department of Preventive Medicine, the Catholic University of Korea College of Medicine, Korea.
  • 3Kim Mi Hye Breast Clinic, Korea.
  • 4Department of Radiology, Ulsan University College of Medicine, Korea.
  • 5Department of Biostatistics, the Catholic University of Korea, Korea.
  • 6Department of Radiology, Soonchunhyang University College of Medicine, Korea.
  • 7Department of General Surgery, the Catholic University of Korea, Korea.
  • 8Department of Internal Medicine, the Catholic University of Korea, Korea.

Abstract

PURPOSE
The purpose of this study was to evaluate the performance of radiologists for mammographic screening, and to analyze interobserver agreement in the interpretation of mammograms.
MATERIALS AND METHODS
50 women were selected as subjects from the patients who were screened with mammograms at two university hospitals. The images were analyzed by five radiologists working independently and without their having any knowledge of the final diagnosis. The interobserver variation was analyzed by using the kappa statistic.
RESULTS
There were moderate agreements for the findings of the parenchymal pattern (k=0.44; 95% CI 0.39-0.49), calcification type (k=0.66; 95% CI 0.60-0.72) and calcification distribution (k=0.43; 95% CI 0.38-0.48). The mean kappa values ranged from 0.66 to 0.42 for the mass findings. The mean kappa value for the final conclusion was 0.44 (95% CI 0.38-0.51). In general, moderate agreement was evident for all the categories that were evaluated.
CONCLUSION
The general agreement was moderate, but there was wide variability in some findings. To improve the accuracy and reduce variability among physicians in interpretation, proper training of radiologists and standardization of criteria are essential for breast screening.

Keyword

Interobserver variability; Mammography; Kappa value

MeSH Terms

Breast
Diagnosis
Female
Hospitals, University
Humans
Mammography
Mass Screening
Observer Variation*
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