PDF(Pubmed)
Abstract：
During the early stages of the pandemic, computed tomography (CT) of the chest, along with serological and clinical data, was frequently utilized in diagnosing COVID-19, particularly in regions facing challenges such as shortages of PCR kits. In these circumstances, CT scans played a crucial role in diagnosing COVID-19 and guiding patient management. The COVID-19 Reporting and Data System (CO-RADS) was established as a standardized reporting system for cases of COVID-19 pneumonia. Its implementation necessitates a high level of agreement among observers to prevent any potential confusion. This study aimed to assess the inter-observer agreement between physicians from different specialties with variable levels of experience in their CO-RADS scoring of CT chests for confirmed COVID-19 patients, and to assess the feasibility of applying this reporting system to those having little experience with it. All chest CT images of patients with positive RT-PCR tests for COVID-19 were retrospectively reviewed by seven observers. The observers were divided into three groups according to their type of specialty (three radiologists, three house officers, and one pulmonologist). The observers assessed each image and categorized the patients into five CO-RADS groups. A total of 630 participants were included in this study. The inter-observer agreement was almost perfect among the radiologists, substantial among a pulmonologist and the house officers, and moderate-to-substantial among the radiologists, the pulmonologist, and the house officers. There was substantial to almost perfect inter-observer agreement when reporting using the CO-RADS among observers with different experience levels. Although the inter-observer variability among the radiologists was high, it decreased compared to the pulmonologist and house officers. Radiologists, house officers, and pulmonologists applying the CO-RADS can accurately and promptly identify typical CT imaging features of lung involvement in COVID-19.
摘要：
在大流行的早期阶段，胸部计算机断层扫描（CT），以及血清学和临床数据，经常用于诊断COVID-19，特别是在面临PCR试剂盒短缺等挑战的地区。在这种情况下,CT扫描在诊断COVID-19和指导患者管理中起着至关重要的作用。建立了COVID-19报告和数据系统（CO-RADS），作为COVID-19肺炎病例的标准化报告系统。它的实施需要观察员之间达成高度一致，以防止任何潜在的混乱。这项研究旨在评估来自不同专业的医生在对确诊的COVID-19患者的CT胸部CO-RADS评分中，具有不同经验水平的观察者之间的共识。并评估将此报告系统应用于经验不足的人的可行性。回顾性分析了7名观察者对COVID-19RT-PCR检测阳性的患者的胸部CT图像。观察员根据他们的专业类型分为三组(三名放射科医生，三名内务人员,和一名肺科医师）。观察者评估每个图像并将患者分为五个CO-RADS组。共有630名参与者参加了这项研究。在放射科医生中，观察者之间的协议几乎是完美的，在肺科医生和内务人员中，在放射科医生中中等到实质性，肺科医生,和房屋官员。在具有不同经验水平的观察员之间使用CO-RADS进行报告时，观察员之间达成了实质性到几乎完美的协议。尽管放射科医师之间的观察者间差异很大，与肺科医生和内务人员相比，它有所下降。放射科医生,房屋官员,肺科医师应用CO-RADS可以准确，及时地识别COVID-19肺部受累的典型CT影像学特征。
