Reliability and validity of subjective radiologist reporting of temporal changes in lumbar spine MRI findings.
Mark J Hancock, Chris G Maher, Jeffrey G Jarvik and 8 others
PMID 34510774WHAT IT FOUND
Radiologists rarely agreed on temporal changes in lumbar MRI findings, with poor reliability for reporting changes despite high agreement on no changes.
False positives were rare but present. Clinicians should avoid basing decisions on these subjective temporal changes.
Key findings
01Inter-rater reliability for reporting temporal changes in lumbar MRI findings was poor, with Kappa values all ≤ 0.24.
02High overall agreement was driven by agreement when no temporal changes were present, with very little agreement on when temporal changes were present.
03False positive temporal changes were reported for most MRI findings, but the rate was generally very low.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study used a small sample size of 50 participants, which may limit the generalizability of the findings. The very short interval between scans for most participants contributed to a low prevalence of temporal changes, making reliability statistics like Kappa difficult to interpret. Radiologists may have used different subjective thresholds for considering a change to have occurred, despite standardized training. The study did not investigate extreme or clinically important changes, such as new fractures or large herniations.
Declared interests
None reported in the provided text.
The easy way to misread this
Do not interpret high percent agreement as evidence of reliable reporting of temporal changes. The agreement was driven by both radiologists reporting no change, while they rarely agreed when a change was actually reported.