Retrospective Cohort Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Jan 28, 2022; 14(1): 19-29
Published online Jan 28, 2022. doi: 10.4329/wjr.v14.i1.19
Effect of training on resident inter-reader agreement with American College of Radiology Thyroid Imaging Reporting and Data System
Yang Du, Meredith Bara, Prayash Katlariwala, Roger Croutze, Katrin Resch, Jonathan Porter, Medica Sam, Mitchell P Wilson, Gavin Low
Yang Du, Meredith Bara, Prayash Katlariwala, Roger Croutze, Katrin Resch, Jonathan Porter, Medica Sam, Mitchell P Wilson, Gavin Low, Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton T6G 2B7, Alberta, Canada
Author contributions: Du Y, Bara M and Low G designed the study; Du Y, Bara M, Croutze R, Resch K, Porter J, Sam M, Wilson MP and Low G performed the research; Du Y, Bara M, Katlariwala P, Low G and Wilson MP analyzed the data and wrote the manuscript; all authors have read and approved the final manuscript.
Institutional review board statement: This retrospective, single-institution observational study was approved by the institutional Health Research Ethics Board (Pro 00104708).
Informed consent statement: This study was exempted from obtaining informed consent.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
Data sharing statement: The raw dataset is available from the corresponding author at yang.du@usask.ca. Consent for data sharing was not obtained but the presented data are anonymized and risk of identification is low.
STROBE statement: Guidelines of the STROBE statement have been adopted.
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: Yang Du, BSc, FRCPC, MD, Doctor, Staff Physician, Department of Radiology and Diagnostic Imaging, University of Alberta, 2A2.41 WMC, 8440-112 St NW, Edmonton T6G 2B7, Alberta, Canada. yang.du@usask.ca
Received: October 12, 2021
Peer-review started: October 12, 2021
First decision: December 9, 2021
Revised: December 21, 2021
Accepted: January 11, 2022
Article in press: January 11, 2022
Published online: January 28, 2022
ARTICLE HIGHLIGHTS
Research background

Thyroid nodules are common and often incidental. The American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) standardizes the use of ultrasound for thyroid nodule risk stratification.

Research motivation

Despite the widespread usage of this system, the learnability of TI-RADS has not been proven in radiology trainees.

Research objectives

To evaluate the inter-reader reliability amongst radiology trainees before and after TI-RADS training.

Research methods

Three PGY-4 radiology residents were evaluated for inter-reader reliability with a 50 thyroid nodule data set before and after a 1-hour didactic teaching session and review of a training data set, with assessment performed 6 wk apart. Performance was compared to a consensus panel reference standard of three fellowship trained radiologists.

Research results

After one session of dedicated TI-RADS training, the radiology residents demonstrated statistically significant improvement in inter-reader agreement in subcategories of "shape", "echogenic foci", "TI-RADS level", and "recommendations" when compared with expert panel consensus. A trend towards higher pooled sensitivity for TI-RADS level 1-4 is also observed.

Research conclusions

Resident trainees demonstrated a statistically significant improvement in inter-reader agreement for both TI-RADS level and recommendations after training. This study demonstrates the learnability of the ACR TI-RADS.

Research perspectives

A multi-institutional and multi-national assessment of radiology resident diagnostic accuracy and inter-reader reliability of ACR TI-RADS classification and recommendations before and after training would improve the generalizability of these results.