Inter-observer Variation of the Alberta Stoke Program Early CT Score (ASPECTS) among Radiologists in the Philippine General Hospital

  • Ryan Jason DL. Urgel
  • Alvin C. Camacho
Keywords: ASPECTS, middle cerebral artery infarct, radiology


Objective. To determine the inter-observer variation of ASPECTS among radiologists in the Philippine General Hospital (PGH), particularly between trainee radiologists and an expert reader.

Methods. Thirty (30) cranial CT scan studies of clinically-diagnosed, non-hemorrhagic stroke patients were analyzed by 9 trainee radiologists (3 fellows, and 3 senior and 3 junior residents) and one expert reader. Data analysis involved determining the levels of agreement within and across groups, and against the expert reader.

Results and Conclusion. There was moderate agreement (kappa = 0.60) between the junior residents and the expert reader, and substantial agreement between the senior residents and the expert reader (kappa = 0.70), as well as between the fellows and the expert reader (kappa = 0.63). Over-all, there was substantial agreement between the trainee radiologists and the expert reader (kappa = 0.63). It can be concluded that the interpretation of trainee radiologists in PGH, particularly that of a senior resident or a fellow, is comparable with that of an expert reader, and can, thus, be useful in cases where an interpretation of a CT scan procedure in a clinically-diagnosed stroke patient is needed.