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Inexperienced clinicians can extract pathoanatomic information from MRI narrative reports with high reproducibility for use in research/quality assurance.

ABSTRACT: Although reproducibility in reading MRI images amongst radiologists and clinicians has been studied previously, no studies have examined the reproducibility of inexperienced clinicians in extracting pathoanatomic information from magnetic resonance imaging (MRI) narrative reports and transforming that information into quantitative data. However, this process is frequently required in research and quality assurance contexts. The purpose of this study was to examine inter-rater reproducibility (agreement and reliability) among an inexperienced group of clinicians in extracting spinal pathoanatomic information from radiologist-generated MRI narrative reports.Twenty MRI narrative reports were randomly extracted from an institutional database. A group of three physiotherapy students independently reviewed the reports and coded the presence of 14 common pathoanatomic findings using a categorical electronic coding matrix. Decision rules were developed after initial coding in an effort to resolve ambiguities in narrative reports. This process was repeated a further three times using separate samples of 20 MRI reports until no further ambiguities were identified (total n = 80). Reproducibility between trainee clinicians and two highly trained raters was examined in an arbitrary coding round, with agreement measured using percentage agreement and reliability measured using unweighted Kappa (k). Reproducibility was then examined in another group of three trainee clinicians who had not participated in the production of the decision rules, using another sample of 20 MRI reports.The mean percentage agreement for paired comparisons between the initial trainee clinicians improved over the four coding rounds (97.9-99.4%), although the greatest improvement was observed after the first introduction of coding rules. High inter-rater reproducibility was observed between trainee clinicians across 14 pathoanatomic categories over the four coding rounds (agreement range: 80.8-100%; reliability range k = 0.63-1.00). Concurrent validity was high in paired comparisons between trainee clinicians and highly trained raters (agreement 97.8-98.1%, reliability k = 0.83-0.91). Reproducibility was also high in the second sample of trainee clinicians (inter-rater agreement 96.7-100.0% and reliability k = 0.76-1.00; intra-rater agreement 94.3-100.0% and reliability k = 0.61-1.00).A high level of radiological training is not required in order to transform MRI-derived pathoanatomic information from a narrative format to a quantitative format with high reproducibility for research or quality assurance purposes.

SUBMITTER: Kent P

PROVIDER: S-EPMC3154850 | biostudies-other | 2011

REPOSITORIES: biostudies-other

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Inexperienced clinicians can extract pathoanatomic information from MRI narrative reports with high reproducibility for use in research/quality assurance.

Kent Peter P Briggs Andrew M AM Albert Hanne B HB Byrhagen Andreas A Hansen Christian C Kjaergaard Karina K Jensen Tue S TS

Chiropractic & manual therapies 20110721 1

<h4>Background</h4>Although reproducibility in reading MRI images amongst radiologists and clinicians has been studied previously, no studies have examined the reproducibility of inexperienced clinicians in extracting pathoanatomic information from magnetic resonance imaging (MRI) narrative reports and transforming that information into quantitative data. However, this process is frequently required in research and quality assurance contexts. The purpose of this study was to examine inter-rater ...[more]

PMID: 21774836

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Project description:We present primary results from the Sequencing Quality Control (SEQC) project, coordinated by the United States Food and Drug Administration. Examining Illumina HiSeq, Life Technologies SOLiD and Roche 454 platforms at multiple laboratory sites using reference RNA samples with built-in controls, we assess RNA sequencing (RNA-seq) performance for sequence discovery and differential expression profiling and compare it to microarray and quantitative PCR (qPCR) data using complementary metrics. At all sequencing depths, we discover unannotated exon-exon junctions, with >80% validated by qPCR. We find that measurements of relative expression are accurate and reproducible across sites and platforms if specific filters are used. In contrast, RNA-seq and microarrays do not provide accurate absolute measurements, and gene-specific biases are observed, for these and qPCR. Measurement performance depends on the platform and data analysis pipeline, and variation is large for transcriptlevel profiling. The complete SEQC data sets, comprising >100 billion reads (10Tb), provide unique resources for evaluating RNA-seq analyses for clinical and regulatory settings. The well-characterized reference RNA samples A (pooled cell lines) and B (human brain) from the MAQC consortium, adding spike-ins of synthetic RNA from the External RNA Control Consortium (ERCC). Samples C and D were then constructed by combining A and B in known mixing ratios, 3:1 and 1:3, respectively. All samples were distributed to several independent sites for RNA-Seq library construction and profiling by Illumina HiSeq 2000 and LifeTech SOLiD 5500 platforms. Also, vendors created their own cDNA libraries that were then distributed to each test site, in order to examine the degree of a M-bM-^@M-^\site effectM-bM-^@M-^] that was independent of the library preparation process. To support an assessment of gene models, samples A and B were also sequenced at independent sites by the Roche 454 platform, providing longer reads. For comparison to other technologies, these data were also compared to the MAQC-I Affymetrix U133 Plus2 microarray, several current microarray platforms, and also assessed by 20,801 PrimePCR reactions.

Project description:Background:Previous studies of patients with neck pain have reported a high variability in prevalence of MRI findings of disc degeneration, disc herniation etc. This is most likely due to small and heterogenous study populations. Reasons for only including small study samples could be the high cost and time-consuming procedures of having radiologists coding the MRIs. Other methods for extracting reliable imaging data should therefore be explored.The objectives of this study were 1) to examine inter-rater reliability among a group of chiropractic master students in extracting information about cervical MRI-findings from radiologists´ narrative reports, and 2) to describe the prevalence of MRI findings in the cervical spine among different age groups in patients above age 18 with neck pain. Method:Adult patients with neck pain (with or without arm pain) seen in a public hospital department between 2011 and 2014 who had an MRI of the cervical spine were identified in the patient registry 'SpineData'. MRI-findings were extracted and quantified from radiologists' narrative reports by second-year chiropractic master students based on a set of coding rules for the process.The inter-rater reliability was quantified with Kappa statistics and the prevalence of the MRI findings were calculated. Results:In total, narrative MRI reports from 611 patients were included. The patients had a mean age of 52?years (SD 13; range 19-87) and 63% were women. The inter-observer agreement in coding MRI findings ranged from substantial (??=?0.78, CI: 0.33-1.00) to almost perfect (??=?0.98, CI: 0.95-1.00).The most prevalent MRI findings were foraminal stenosis (77%), uncovertebral arthrosis (74%) and disc degeneration (67%) while the least prevalent findings were nerve root compromise (2%) and Modic changes type 2 (6%). Modic type 1 was mentioned in 25% of the radiologists' reports. The prevalence of all findings increased with age, except disc herniation which was most prevalent for patients in their forties. Conclusion:MRI-findings from radiologists' narrative reports can reliably be extracted by chiropractic master students with a minimum of training. Degenerative findings in the cervical spine were most commonly found at levels C5/C6 and C6/C7 and increased with age.

Dataset Information

Inexperienced clinicians can extract pathoanatomic information from MRI narrative reports with high reproducibility for use in research/quality assurance.

Publications

Inexperienced clinicians can extract pathoanatomic information from MRI narrative reports with high reproducibility for use in research/quality assurance.

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