Are you reading what we are reading? The effect of who interprets medical images on estimates of diagnostic test accuracy in systematic reviews
- 1 August 2007
- journal article
- review article
- Published by Oxford University Press (OUP) in The British Journal of Radiology
- Vol. 80 (956), 674-677
- https://doi.org/10.1259/bjr/83042364
Abstract
Observer variation and error in the interpretation of medical images is substantial and has been described as Radiology's Achilles' heel. The enormous development in imaging technologies has brought with it an increase in the complexity and volume of images produced. There is also increased diversity as to who interprets medical images. Whilst the influence of the observer on diagnostic test performance is frequently ignored, there is evidence that this influences estimates of accuracy. Characteristics of observers that should be considered when designing systematic reviews of diagnostic test accuracy are: allocation of images to be read by observers; number, experience and training of observers; profession of observers; and assessment of observer variability and examination of its effect on test accuracy. This information could be used to inform study appraisal, data synthesis, and the investigation of sources of heterogeneity. Establishing the effect of the role of the observer on estimates of accuracy and explaining heterogeneity is important for informing the delivery of these potentially expensive and resource-intensive imaging technologies and the continuing debate about who should read the images.Keywords
This publication has 19 references indexed in Scilit:
- Evaluation of QUADAS, a tool for the quality assessment of diagnostic accuracy studiesBMC Medical Research Methodology, 2006
- Variability in interpretation of chest radiographs among Russian clinicians and implications for screening programmes: observational studyBMJ, 2005
- Waiting times for scans to decrease, vows Department of HealthBMJ, 2005
- Evidence base of clinical diagnosis: Designing studies to ensure that estimates of test accuracy are transferableBMJ, 2002
- Evidence base of clinical diagnosis: The architecture of diagnostic researchBMJ, 2002
- Measuring the Effects of Image Interpretation: An Evaluative FrameworkClinical Radiology, 2001
- Bias in plain film reading performance studiesThe British Journal of Radiology, 2001
- Radiology's Achilles' heel: error and variation in the interpretation of the Röntgen image.The British Journal of Radiology, 1997
- Use of Methodological Standards in Diagnostic Test ResearchJAMA, 1995
- On the Scientific Evaluation of Diagnostic ProceduresRadiology, 1949