J N Ramalho1, G Tedesqui2, M Ramalho3, R S Azevedo4, M Castillo2. 1. From the Departments of Neuroradiology (J.N.R., G.T., M.C.) Centro Hospitalar de Lisboa Central (J.N.R.), Lisbon, Portugal Joana-Ramalho@netcabo.pt. 2. From the Departments of Neuroradiology (J.N.R., G.T., M.C.). 3. Radiology (M.R.), University of North Carolina Hospital, Chapel Hill, North Carolina Hospital Garcia de Orta (M.R.), Almada, Portugal. 4. Faculdade de Medicina da Universidade de São Paulo (R.S.A.), São Paulo, Brazil.
Abstract
BACKGROUND AND PURPOSE: Because evidence-based articles are difficult to recognize among the large volume of publications available, some journals have adopted evidence-based medicine criteria to classify their articles. Our purpose was to determine whether an evidence-based medicine classification used by a subspecialty-imaging journal allowed consistent categorization of levels of evidence among different raters. MATERIALS AND METHODS: One hundred consecutive articles in the American Journal of Neuroradiology were classified as to their level of evidence by the 2 original manuscript reviewers, and their interobserver agreement was calculated. After publication, abstracts and titles were reprinted and independently ranked by 3 different radiologists at 2 different time points. Interobserver and intraobserver agreement was calculated for these radiologists. RESULTS: The interobserver agreement between the original manuscript reviewers was -0.2283 (standard error = 0.0000; 95% CI, -0.2283 to -0.2283); among the 3 postpublication reviewers for the first evaluation, it was 0.1899 (standard error = 0.0383; 95% CI, 0.1149-0.2649); and for the second evaluation, performed 3 months later, it was 0.1145 (standard error = 0.0350; 95% CI, 0.0460-0.1831). The intraobserver agreement was 0.2344 (standard error = 0.0660; 95% CI, 0.1050-0.3639), 0.3826 (standard error = 0.0738; 95% CI, 0.2379-0.5272), and 0.6611 (standard error = 0.0656; 95% CI, 0.5325-0.7898) for the 3 postpublication evaluators, respectively. These results show no-to-fair interreviewer agreement and a tendency to slight intrareviewer agreement. CONCLUSIONS: Inconsistent use of evidence-based criteria by different raters limits their utility when attempting to classify neuroradiology-related articles.
BACKGROUND AND PURPOSE: Because evidence-based articles are difficult to recognize among the large volume of publications available, some journals have adopted evidence-based medicine criteria to classify their articles. Our purpose was to determine whether an evidence-based medicine classification used by a subspecialty-imaging journal allowed consistent categorization of levels of evidence among different raters. MATERIALS AND METHODS: One hundred consecutive articles in the American Journal of Neuroradiology were classified as to their level of evidence by the 2 original manuscript reviewers, and their interobserver agreement was calculated. After publication, abstracts and titles were reprinted and independently ranked by 3 different radiologists at 2 different time points. Interobserver and intraobserver agreement was calculated for these radiologists. RESULTS: The interobserver agreement between the original manuscript reviewers was -0.2283 (standard error = 0.0000; 95% CI, -0.2283 to -0.2283); among the 3 postpublication reviewers for the first evaluation, it was 0.1899 (standard error = 0.0383; 95% CI, 0.1149-0.2649); and for the second evaluation, performed 3 months later, it was 0.1145 (standard error = 0.0350; 95% CI, 0.0460-0.1831). The intraobserver agreement was 0.2344 (standard error = 0.0660; 95% CI, 0.1050-0.3639), 0.3826 (standard error = 0.0738; 95% CI, 0.2379-0.5272), and 0.6611 (standard error = 0.0656; 95% CI, 0.5325-0.7898) for the 3 postpublication evaluators, respectively. These results show no-to-fair interreviewer agreement and a tendency to slight intrareviewer agreement. CONCLUSIONS: Inconsistent use of evidence-based criteria by different raters limits their utility when attempting to classify neuroradiology-related articles.