Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Nov 28, 2022; 14(11): 367-374
Published online Nov 28, 2022. doi: 10.4329/wjr.v14.i11.367
Interobserver reliability between pediatric radiologists and residents in ultrasound evaluation of intraventricular hemorrhage in premature infants
Muhammad Danish Barakzai, Ayimen Khalid, Zara Za Sheer, Faheemullah Khan, Naila Nadeem, Noman Khan, Kiran Hilal
Muhammad Danish Barakzai, Department of Radiology, The Hospital for Sick Children, Toronto 555, Canada
Muhammad Danish Barakzai, Ayimen Khalid, Faheemullah Khan, Naila Nadeem, Noman Khan, Kiran Hilal, Department of Radiology, Aga Khan University Hospital, Karachi 74800, Pakistan
Zara Za Sheer, Community Health Sciences, Aga Khan University Hospital, Karachi 74800, Pakistan
Author contributions: Barakzai MD, Khalid A, Sheer ZZ, Nadeem N and Hilal K designed the research study; Barakzai MD, Nadeem N, Khan N and Khan F performed the research; Khalid A, Sheer ZZ, Khan N and Hilal K contributed new reagents and analytic tools; Khalid A, Sheer ZZ, Khan F and Khan N analyzed the data and wrote the manuscript; All authors have read and approve the final manuscript.
Institutional review board statement: Exemption from ethical approval was granted by Ethics Review Committee.
Informed consent statement: Individual informed consent was waived off by the Institutional Review Committee due to minimal risk to the subjects, observational nature of the study and anonymized imaging review.
Conflict-of-interest statement: All authors of this manuscript have no conflict of interest to disclose.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at kiran.hilal@aku.edu. Participants gave informed consent for anonymized data sharing.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kiran Hilal, FCPS, MBBS, Assistant Professor, Department of Radiology, Aga Khan University Hospital, Stadium Road, Karachi 74800, Pakistan.kiran.hilal@aku.edu
Received: March 13, 2022
Peer-review started: March 13, 2022
First decision: May 12, 2022
Revised: May 25, 2022
Accepted: September 21, 2022
Article in press: September 21, 2022
Published online: November 28, 2022
Abstract
BACKGROUND

Germinal matrix intraventricular hemorrhage (IVH) may contribute to significant morbidity and mortality in premature infants. Timely identification and grading of IVH affect decision-making and clinical outcomes. There is possibility of misinterpretation of the ultrasound appearances, and the interobserver variability has not been investigated between radiology resident and board-certified radiologist.

AIM

To assess interobserver reliability between senior radiology residents performing bedside cranial ultrasound during on-call hours and pediatric radiologists.

METHODS

From June 2018 to June 2020, neonatal cranial ultrasound examinations were performed in neonatal intensive care unit. Ultrasound findings were recorded by the residents performing the ultrasound and the pediatric attending radiologists.

RESULTS

In total, 200 neonates were included in the study, with a mean gestational age of 30.9 wk. Interobserver agreement for higher grade (Grade III & IV) IVH was excellent. There was substantial agreement for lower grade (Grade I & II) IVH.

CONCLUSION

There is strong agreement between radiology residents and pediatric radiologists, which is higher for high grade IVHs.

Keywords: Ultrasound head, Neonatal cranial ultrasound, Cranial ultrasound, Intraventricular hemorrhage, Neonatal intraventricular hemorrhage

Core Tip: While possibility of interobserver variability exists in all imaging modalities, it is the highest in ultrasound. Interobserver variability in ultrasound may result from technical errors such as inadequate gain/depth settings, incomplete anatomic interrogation, or error in misinterpretation. During ultrasound examination, both the image acquisition and interpretive skills improve with increasing experience. Differences in identification and grading of intraventricular hemorrhage may affect the clinical outcome, and the subsequent management options.