Chan, TY, England, A, Meredith, SM and McWilliams, RG (2016) Radiologist variability in assessing the position of the cavoatrial junction on chest radiographs. The British Journal of Radiology, 89 (1065). 20150965 - 20150965. ISSN 0007-1285

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OBJECTIVE: To assess the variability in identifying the cavoatrial junction (CAJ) on chest X-rays (CXRs) amongst radiologists. METHODS: 23 radiologists (13 consultants and 10 trainees) assessed 25 posteroanterior erect CXRs (including 8 duplicates) and marked the positions of the CAJ. Differences in the CAJ position both within and between observers were evaluated and reported as limits of agreement (LOA), repeatability coefficients (RCs) and intraclass correlation coefficients and were displayed graphically with Bland–Altman plots. RESULTS: The mean difference for within-observer assessments was −0.2 cm (95% LOA, −1.5 to +1.1 cm) and between observers, it was −0.3 cm (95% LOA, −2.5 to +1.8 cm). Intraobserver RCs were marginally lower for consultants than for trainees (1.1 vs 1.5). RCs between observers were comparable (2.1 vs 2.2) for consultants and trainees, respectively. CONCLUSION: This study detected a large interobserver variability of the CAJ position (up to 4.3 cm). This is a significant finding considering that the length of the superior vena cava is reported to be approximately 7 cm. We conclude that there is poor consensus regarding the CAJ position amongst radiologists. ADVANCES IN KNOWLEDGE: No comparisons exist between radiologists in determining CAJ position from CXRs. This report provides evidence of the large observer variability amongst radiologists and adds to the discussion regarding the use of CXRs in validating catheter tip location systems.

Item Type: Article
Additional Information: The final version of this article and all relevant information can be found at;
Subjects: Q Science > Q Science (General)
R Medicine > R Medicine (General)
Divisions: Faculty of Medicine and Health Sciences > School of Allied Health Professions
Depositing User: Symplectic
Date Deposited: 18 Jun 2020 11:47
Last Modified: 18 Jun 2020 11:47

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