Diagnostic agreement nearly perfect between radiologists and clinical experts with use of patient-reported symptom information
By Elana Gotkine HealthDay Reporter
MONDAY, Nov. 4, 2024 (HealthDay News) — Patient-reported symptom information allows radiologists to achieve near-perfect diagnostic agreement with clinical experts for interpretation of lumbar spine magnetic resonance imaging (MRI), according to a study published online Oct. 29 in Radiology.
Rene Balza, M.D., from Massachusetts General Hospital in Boston, and colleagues examined whether patient-reported symptom information can improve the interpretation of lumbar spine MRI for radiologists compared with spine specialists in a prospective, single-center study involving 240 participants who completed pre-MRI symptom questionnaires. Radiologists recorded pain generators in consecutive participants, alternating interpretations with versus without symptom questionnaire results (SQRs) to create two groups. A numeric scale of 0 to 100 was used to record diagnostic certainty.
The researchers found that agreements on pain generators when radiologists were compared with specialists were almost perfect for interpretations using SQRs (κ, 0.82, 0.88, and 0.84 for type, level, and side, respectively), but were only fair-to-moderate for interpretations not using SQRs (κ, 0.26, 0.51, and 0.30 for type, level, and side, respectively). Diagnostic certainty was higher for MRI interpretations using versus not using SQRs. For MRI interpretations using SQRs, interrater agreements were substantial, but they were only fair-to-moderate for MRI interpretations not using SQRs (κ = 0.65 to 0.78 versus 0.24 to 0.49).
“Without symptom knowledge, agreement and diagnostic certainty were decreased,” the authors write. “Additional studies are necessary to assess impact on treatment decisions and patient outcomes.”
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