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J Child Neurol. 2014 Dec;29(12):1685-91. doi: 10.1177/0883073813506491. Epub 2013 Dec 5.

Reproducibility of detecting silent cerebral infarcts in pediatric sickle cell anemia.

Author information

1
Division of Hematology, Oncology & Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
2
Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA.
3
Electronic Radiology Lab, Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA.
4
Department of Pediatrics, Washington University School of Medicine, Saint Louis, MO, USA.
5
Division of Neuroradiology, Johns Hopkins Hospital, Baltimore, MD, USA.
6
Pediatric Hematology, Johns Hopkins Hospital, Baltimore, MD, USA.
7
Division of Pediatric Neuroradiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
8
Vanderbilt Meharry Center of Excellence in Sickle Cell Disease, Division of Pediatric Hematology/Oncology, Vanderbilt University Medical Center, Nashville, TN, USA m.debaun@vanderbilt.edu.

Abstract

Detecting silent cerebral infarcts on magnetic resonance images (MRIs) in children with sickle cell anemia is challenging, yet reproducibility of readings has not been examined in this population. We evaluated consensus rating, inter-, and intra-grader agreement associated with detecting silent cerebral infarct on screening MRI in the Silent Infarct Transfusion Trial. Three neuroradiologists provided consensus decisions for 1073 MRIs. A random sample of 53 scans was reanalyzed in blinded fashion. Agreement between first and second consensus ratings was substantial (κ = 0.70, P < .0001), as was overall intergrader agreement (κ = 0.76, P < .0001). In the test-retest sample, intragrader agreement ranged from κ of 0.57 to 0.76. Consensus decisions were more concordant when MRIs contained more than one larger lesions. Routine use of MRI to screen for silent cerebral infarcts in the research setting is reproducible in sickle cell anemia and agreement among neuroradiologists is sufficient.

KEYWORDS:

reliability testing; sickle cell disease; stroke

PMID:
24309240
PMCID:
PMC4096057
DOI:
10.1177/0883073813506491
[Indexed for MEDLINE]
Free PMC Article
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