2083791 Inter-Observer Variation In Ultrasonographic Detection Of Gallbladder Diseases

Objectives: Ultrasounds are by now the most widely used tool to assess gallbladder diseases and no other imaging technique can reproduce its accuracy. Abdominal ultrasound is indeed considered the systematic first-line investigation for the management of patients with gallbladder disease. Aim of this study was to evaluate the inter-observer agreement among different observers attending an Italian School of Ultrasound Methods: From march 2013 to november 2013 94 routine ultrasonographic examinations of the gallbladder were consecutively performed. A digital video movie of the gallbladder was recorded for each patient. Three different examiners were involved in this study: a teacher of the school of ultrasound, an experienced trainee and a low experienced student. All observers independently and blindly reviewed the video recording of each examination. For each examination was evaluated the presence or absence of cholelithiasis or gallbladder wall diseases (polyps, cholesterolosis, cancer); absence of lesions and/or presence of septa and or dysmorphia were considered as the same group. Kappa statistics were used to assess interobserver agreement by employing MedCalc Statistical Software (Mariakerke, Belgium) Results: Inter-observer agreement for cholelithiasis was ‘‘almost perfect’’ (k50.86) only between the two trained operators while agreement between a low trained examiner and both the others was ‘‘moderate’’ (k50.60 and k50.56). Inter-rater agreement was form ‘‘fair’’ to ‘‘moderate’’ in evaluating gallbladder wall diseases (just reaching a k50,52 between the two trained ultrasonographer). All observers reached a ‘‘substantial’’ agreement (ranging from k50.69 to k50.75) in confirming any of a gallbladder disease. Conclusions: This study suggests that both ‘‘novice’’ and ‘‘expert’’ ultrasonographers substantially agree in the presence/absence of gallbladder diseases while agreement on what a kind of disease is reached only cholelitiasis and after an adequate training.