Inter and intea-observer variation in ultrasonographic detection of gallstones: The Multicenter Italian Study on Epidemiology of Cholelithiasis (M.I.COL.)

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Abstract
Inter and intea-observer agreement in classifying the presence of gallstones by ultrasonographic images according to established criteria was studied. A film recording of 50 routine ultrasonographic examinations of the gallbladder was read by each of the 46 observers who participated in the Multicenter Italian Study on Epidemiology of Cholelithiasis (M.I.COL.). The overall Kappa score for inter-observer agreement was 0.649, while intea-observer agreement was “good” or “excellent” (Kappa scores >0.60) in 75% of the observers. No statistical difference for inter-observer agreement between “novices” and “expert” echographers was found in the overall Kappa statistic or in category-specific Kappa scores (gallstone, no gallstone, doubtful and inconclusive examinations) The present study suggests that the development of explicit criteria by a group of trained echographers does not eliminate inter-and intea-observer disagreement in categorizing subjects for gallbladder stones.