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Observer variability in the assessment of CT coronary angiography and coronary artery calcium score: substudy of the Scottish COmputed Tomography of the HEART (SCOT-HEART) trial.

Williams MC, Golay SK, Hunter A, Weir-McCall JR, Mlynska L, Dweck MR, Uren NG, Reid JH, Lewis SC, Berry C, van Beek EJ, Roditi G, Newby DE, Mirsadraee S - Open Heart (2015)

Bottom Line: Observer variability of calcium score was excellent for calcium scores below 1000.More segments were categorised as uninterpretable with 64-multidetector compared to 320-multidetector CTCA (10.1% vs 2.6%, p<0.001) but there was no difference in observer variability.NCT01149590.

View Article: PubMed Central - PubMed

Affiliation: University of Edinburgh/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh , Edinburgh, Lothian , UK.

ABSTRACT

Introduction: Observer variability can influence the assessment of CT coronary angiography (CTCA) and the subsequent diagnosis of angina pectoris due to coronary heart disease.

Methods: We assessed 210 CTCAs from the Scottish COmputed Tomography of the HEART (SCOT-HEART) trial for intraobserver and interobserver variability. Calcium score, coronary angiography and image quality were evaluated. Coronary artery disease was defined as none (<10%), mild (10-49%), moderate (50-70%) and severe (>70%) luminal stenosis and classified as no (<10%), non-obstructive (10-70%) or obstructive (>70%) coronary artery disease. Post-CTCA diagnosis of angina pectoris due to coronary heart disease was classified as yes, probable, unlikely or no.

Results: Patients had a mean body mass index of 29 (28, 30) kg/m(2), heart rate of 58 (57, 60)/min and 62% were men. Intraobserver and interobserver agreements for the presence or absence of coronary artery disease were excellent (95% agreement, κ 0.884 (0.817 to 0.951) and good (91%, 0.791 (0.703 to 0.879)). Intraobserver and interobserver agreement for the presence or absence of angina pectoris due to coronary heart disease were excellent (93%, 0.842 (0.918 to 0.755) and good (86%, 0.701 (0.799 to 0.603)), respectively. Observer variability of calcium score was excellent for calcium scores below 1000. More segments were categorised as uninterpretable with 64-multidetector compared to 320-multidetector CTCA (10.1% vs 2.6%, p<0.001) but there was no difference in observer variability.

Conclusions: Multicentre multidetector CTCA has excellent agreement in patients under investigation for suspected angina due to coronary heart disease.

Trial registration number: NCT01149590.

No MeSH data available.


Related in: MedlinePlus

Bland-Altman plots for intra and inter observer variability for the assessment of total Agatston score (dotted lines represent the limits of agreement).
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OPENHRT2014000234F2: Bland-Altman plots for intra and inter observer variability for the assessment of total Agatston score (dotted lines represent the limits of agreement).

Mentions: There were no differences in Agatston calcium score on intraobserver or interobserver assessment (373 (95% CI 224 to 505) Agatston units versus 278 (95% CI 202 to 354) Agatston units, p=0.138 and 290 (95% CI 210 to 370) Agatston units, p=0.191). Bland-Altman plots showed that the level of calcification systematically affected intraobserver and interobserver variability of the Agatston score (figure 2) with both intraobserver and interobserver variability increasing as the calcium score increased. However, for patients with calcium score of less than 1000, the intraobserver and interobserver was excellent (figure 3).


Observer variability in the assessment of CT coronary angiography and coronary artery calcium score: substudy of the Scottish COmputed Tomography of the HEART (SCOT-HEART) trial.

Williams MC, Golay SK, Hunter A, Weir-McCall JR, Mlynska L, Dweck MR, Uren NG, Reid JH, Lewis SC, Berry C, van Beek EJ, Roditi G, Newby DE, Mirsadraee S - Open Heart (2015)

Bland-Altman plots for intra and inter observer variability for the assessment of total Agatston score (dotted lines represent the limits of agreement).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4442169&req=5

OPENHRT2014000234F2: Bland-Altman plots for intra and inter observer variability for the assessment of total Agatston score (dotted lines represent the limits of agreement).
Mentions: There were no differences in Agatston calcium score on intraobserver or interobserver assessment (373 (95% CI 224 to 505) Agatston units versus 278 (95% CI 202 to 354) Agatston units, p=0.138 and 290 (95% CI 210 to 370) Agatston units, p=0.191). Bland-Altman plots showed that the level of calcification systematically affected intraobserver and interobserver variability of the Agatston score (figure 2) with both intraobserver and interobserver variability increasing as the calcium score increased. However, for patients with calcium score of less than 1000, the intraobserver and interobserver was excellent (figure 3).

Bottom Line: Observer variability of calcium score was excellent for calcium scores below 1000.More segments were categorised as uninterpretable with 64-multidetector compared to 320-multidetector CTCA (10.1% vs 2.6%, p<0.001) but there was no difference in observer variability.NCT01149590.

View Article: PubMed Central - PubMed

Affiliation: University of Edinburgh/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh , Edinburgh, Lothian , UK.

ABSTRACT

Introduction: Observer variability can influence the assessment of CT coronary angiography (CTCA) and the subsequent diagnosis of angina pectoris due to coronary heart disease.

Methods: We assessed 210 CTCAs from the Scottish COmputed Tomography of the HEART (SCOT-HEART) trial for intraobserver and interobserver variability. Calcium score, coronary angiography and image quality were evaluated. Coronary artery disease was defined as none (<10%), mild (10-49%), moderate (50-70%) and severe (>70%) luminal stenosis and classified as no (<10%), non-obstructive (10-70%) or obstructive (>70%) coronary artery disease. Post-CTCA diagnosis of angina pectoris due to coronary heart disease was classified as yes, probable, unlikely or no.

Results: Patients had a mean body mass index of 29 (28, 30) kg/m(2), heart rate of 58 (57, 60)/min and 62% were men. Intraobserver and interobserver agreements for the presence or absence of coronary artery disease were excellent (95% agreement, κ 0.884 (0.817 to 0.951) and good (91%, 0.791 (0.703 to 0.879)). Intraobserver and interobserver agreement for the presence or absence of angina pectoris due to coronary heart disease were excellent (93%, 0.842 (0.918 to 0.755) and good (86%, 0.701 (0.799 to 0.603)), respectively. Observer variability of calcium score was excellent for calcium scores below 1000. More segments were categorised as uninterpretable with 64-multidetector compared to 320-multidetector CTCA (10.1% vs 2.6%, p<0.001) but there was no difference in observer variability.

Conclusions: Multicentre multidetector CTCA has excellent agreement in patients under investigation for suspected angina due to coronary heart disease.

Trial registration number: NCT01149590.

No MeSH data available.


Related in: MedlinePlus