Circulation, Vol 53, 627-632, Copyright © 1976 by American Heart Association
LM Zir, SW Miller, RE Dinsmore, JP Gilbert and JW Harthorne
Four experienced coronary angiographers (two radiologists and two
cardiologists) independently assessed the location and degree of coronary
artery stenosis, and the location and degree of left ventricular wall
motion abnormalities in 20 coronary angiograms. Marked interobserver
variability was noted in quantifying percent coronary artery stenosis and
degree of left ventricular wall motion abnormalities. For example, in only
13/20 (65%) of the coronary angiograms did all observers agree about the
significance of a stenosis (defined as greater than 50% in diameter luminal
narrowing) in the proximal or mid left anterior descending coronary artery.
In 3/20 (15%) angiograms there was disagreement by at least one observer
about the significance of lesions noted in the main left coronary artery.
The ventricle was divided into five segments and the degree of wall motion
abnormality graded into six categories of increasing severity from normal
to dyskinesis. There was a 42% mean disagreement among all four observers
where a disagreement between observers was defined as any difference in
grading wall motion abnormalities. Interobserver variability reveals a
significant limitation of coronary angiography.
ARTICLES
Interobserver variability in coronary angiography
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