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Inter-Rater Reliability of Carotid Intima-Media Thickness Measurements in a Multicenter Cohort Study

 Jung Hyun Lee  ;  Dong Phil Choi  ;  Jee-Seon Shim  ;  Dae Jung Kim  ;  Sung-Ha Park  ;  Hyeon Chang Kim 
 Journal of Health Informatics and Statistics (보건정보통계학회지), Vol.41(1) : 49-56, 2016 
Journal Title
 Journal of Health Informatics and Statistics (보건정보통계학회지) 
Issue Date
Carotid intima-media thickness ; Plaque presence ; Inter-rater reliability ; Intraclass correlation coefficient ; Kappa statistics
Objectives: Carotid intima-media thickness (CIMT) and the presence of carotid artery plaque are widely used as preclinical markers of atherosclerosis. Due to operator dependency in measuring CIMT, it is important to evaluate the reliability of measuring CIMT and plaque between centers in a multicenter study. The purpose of this study is to evaluate the inter-rater reliability of CIMT and plaque presence among three clinical centers of the Cardiovascular and Metabolic Disease Etiology Research Center (CMERC). Methods: Twenty people without known cardiovascular disease (age 37-64) were enrolled during 2014-2015, and their left and right carotid arteries were examined repeatedly with ultrasonography for CIMT measurements at three clinical centers according to a predetermined protocol. Maximum and mean values of CIMT at distal common carotid artery were recorded. Plaque presence at a carotid artery was checked by an operator. The reliability of CIMT and carotid plaque presence was assessed using an intraclass correlation coefficient (ICC) and kappa statistics, respectively. Results: Calculated ICC was 0.647 (95% CI: 0.487-0.779) for maximum CIMT, and 0.758 (95% CI: 0.632-0.854) for mean CIMT. In Bland Altman plot, most observed values were distributed within mean difference ±1.96 SD ranges. Kappa statistics of plaque presence between two centers were 0.304 (center 1 and 2), 0.507 (center 1 and 3), and 0.606 (center 2 and 3), respectively, while Fleiss kappa for overall agreement was 0.445. Conclusions: The inter-rater reliability of CIMT measurements among three clinical centers turned out to be high, and the agreement of measuring carotid plaque presence was fair.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hyeon Chang(김현창) ORCID logo https://orcid.org/0000-0001-7867-1240
Park, Sung Ha(박성하) ORCID logo https://orcid.org/0000-0001-5362-478X
Shim, Jee Seon(심지선) ORCID logo https://orcid.org/0000-0002-8671-3153
Lee, Jung Hyun(이정현)
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