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| 1 | Reliability of ultrasound ovarian-adnexal reporting and data system amongst less experienced readers before and after training显示文摘BACKGROUND The 2018 ovarian-adnexal reporting and data system(O-RADS)guidelines are aimed at providing a system for consistent reports and risk stratification for ovarian lesions found on ultrasound.It provides key characteristics and findings for lesions,a lexicon of descriptors to communicate findings,and risk characterization and associated follow-up recommendation guidelines.However,the ORADS guidelines have not been validated in North American institutions or amongst less experienced readers.AIM To evaluate the diagnostic accuracy and inter-reader reliability of ultrasound ORADS risk stratification amongst less experienced readers in a North American institution with and without pre-test training.METHODS A single-center retrospective study was performed using 100 ovarian/adnexal lesions of varying O-RADS scores.Of these cases,50 were allotted to a training cohort and 50 to a testing cohort via a non-randomized group selection process in order to approximately equal distribution of O-RADS categories both within and between groups.Reference standard O-RADS scores were established through consensus of three fellowship-trained body imaging radiologists.Three PGY-4 residents were independently evaluated for diagnostic accuracy and inter-reader reliability with and without pre-test O-RADS training.Sensitivity,specificity,positive predictive value,negative predictive value(NPV),and area under the curve(AUC)were used to measure accuracy.Fleiss kappa and weighted quadratic(pairwise)kappa values were used to measure inter-reader reliability.Statistical significance was P<0.05.RESULTS Mean patient age was 40±16 years with lesions ranging from 1.2 to 22.5 cm.Readers demonstrated excellent specificities(85%-100%pre-training and 91%-100%post-training)and NPVs(89%-100%pre-training and 91-100%post-training)across the O-RADS categories.Sensitivities were variable(55%-100%pre-training and 64%-100%post-training)with malignant ORADS 4 and 5 Lesions pre-training and post-training AUC values of 0.87-0.95 and 0.94-098,respectively(P<0.001).Nineteen of 22(86%)misclassified cases in pre-training were related to mischaracterization of dermoid features or wall/septation morphology.Fifteen of 17(88%)of posttraining misclassified cases were related to one of these two errors.Fleiss kappa inter-reader reliability was‘good’and pairwise inter-reader reliability was‘very good’with pre-training and post-training assessment(k=0.76 and 0.77;and k=0.77-0.87 and 0.85-0.89,respectively).CONCLUSION Less experienced readers in North America achieved excellent specificities and AUC values with very good pairwise inter-reader reliability.They may be subject to misclassification of potentially malignant lesions,and specific training around dermoid features and smooth vs irregular inner wall/septation morphology may improve sensitivity. | Prayash Katlariwala Mitchell P Wilson Yeli Pi Baljot S Chahal Roger Croutze Deelan Patel Vimal Patel Gavin Low | 2022 | World Journal of Radiology2022，14，9： | 2 |
| 2 | Significance of the positive crossmatch test in kidney transplantation 显示文摘 | Patel R Terasaki PI | 1969 | N Engl J Med1969，280，14： | 1 |
| 3 | Significance of the positive crossmatch test in kidney transplantation 显示文摘 | Patel R Terasaki PI | 1969 | N Engl J Med1969，280，14： | 1 |
| 4 | The gene for the peripheral myelin protein PMP-22 is a candidate for CharcotMarie-Tooth disease type 1A显示文摘 | Patel PI Roa BB Welcher AA | 1992 | Nat Genet1992，1，3： | 1 |
| 5 | Significance of the positive crossmatch test in kidney transplantation 显示文摘 | Patel R Terasaki PI | 1969 | N Engl J Med1969，280，14： | 1 |
| 6 | Glucocorticosteroids stimulate the activity of the promoters of peripheral myelin protein-22 and protein zero genes in Schwann cells 显示文摘 | Desarnaud F Bidichandani S Patel PI | 2000 | Brain Res2000，865，1： | 1 |
| 7 | Identification of a positive regulatory element in the myelin-specific promoter of the PMP22 gene显示文摘 | Hai M Bidichandani SI Patel PI | 2001 | J Neurosci Res2001，65，： | 1 |
| 8 | Human frataxin maintains mitochondrial iron homeostasis in Saccharomyces cerevisiae显示文摘 | Cavadini P Gellera C Patel PI | | 0，，： | 1 |
| 9 | Murine monoclonal IgG antibodies:differences in their IgG isotypes can affect the antibody effector activity when using human cells显示文摘 | Lobo PI Patel HC | 1997 | Immunol Cell Biol1997，75，3： | 1 |
| 10 | current in anagement of extracrani- al carotid aretey disease 显示文摘 | Farics PI Chacr RA Patel S | 2006 | Vascular and Endovascular surgery2006，40，3： | 1 |
| 11 | Expert Consensus on Nutritional Support for Children with Congenital Heart Disease(2023 Edition)显示文摘The second edition of the expert consensus on pediatric nutrition was formed based on a global update of pedia-tric nutrition guidelines or consensus worldwide,the management of congenital heart disease,and the results of multi-center clinical nutrition research for congenital heart disease following thefirst Chinese consensus edition of 2016.The consensus was also shaped by the results of three discussion sessions and two questionnaires con-ducted by the 13-member collaboration group.This process was informed by both clinical guidelines and expert consensus.The quality of literature,both in English and Chinese,and the level of recommendations were evaluated using the Grading of Recommendations Assessment,Development,and Evaluations(GRADE)system. | Xuming Mo Wei Cai Jirong Qi Zhuoming Xu Ying Wang Weihui Yan Shoujun Li Nianguo Dong Xinxin Chen Jinfen Liu Qiang Shu Jimei Chen Haibo Zhang Hao Zhang Quansheng Xing Qi An Xiaofeng Li Xu Wang Yan He Junwu Su Taibing Fan Teng Ming Weibing Tang Li Hong Jinghao Zheng Ming Ye Guocheng Sun Yiqun Ding Liang Tao Yifeng Yang Zhongshi Wu Hua Cao Qiang Wang Keming Yang Libing Zhang Ping Wen Yanqin Cui Bo Zhai Yong Zou Qingya Tang Rui Chen Chun Wu Zhiyu Feng Caixia Liu Yaping Mi Rufang Zhang Ke Lin Xin Li Mingan Pi Xiangming Fan Shanshan Shi Peng Huang Zhengxia Pan Jiafeng Qi Renwei Chen Shuguang Tao Yaqin Shu Huifeng Zhang Lan Jiang Min Da Nishant Patel Liang Hu Cardiac Surgery Group of Pediatric Surgery Society of Chinese Medical Association and Parenteral Enteral Nutrition Society of Chinese Medical Association | 2023 | Congenital Heart Disease2023，18，6： | 0 |
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