Expert evaluation of stratification system for nodular thyroid pathology diagnostics

Timofeeva L.A., Shubin L.B.

Purpose. A comparative evaluation of the effectiveness of the application of modern technologies for image quality assessment with ultrasonic diagnostics of thyroid nodules.

Materials and methods. An independent blind prospective direct study to evaluate the original program of ultrasound images evaluation using a computer was carry out.

An independent blind prospective direct study was conducted to evaluate the original program of ultrasound images evaluation using a computer. TIRADS system was taken as a reference. 205 patients (aged 52,6 ± 12,3 years) were examined. Three experts participated by conducting parallel studies on ultrasonic devices Aplio XG (Toshiba, Japan), SonoScape in B-mode, colour Doppler sonography and Power Doppler. Data were entered into the original database. The views of experts were analyzed by single criteria and were organized by TIRADS and and then were evaluated using the proposed program.

Statistical analysis was carried out by the technology of disagreement level examination applying the technique of interrater agreement using Cohen's Kappa.

Results. Modern assessment systems suggest formation of a simple matrix for diagnosis and diagnostic tactics development. Using the method of multiple comparisons (Multiple Comparisons) it was found that only benign and malignant diseases of the thyroid gland had statistically significant differences in signs. On this basis, a computer program for the evaluation of the images of the nodular pathology of the thyroid without extensive classifier. Grading by TIRADS found agreement of conclusions in 91.2%. When applying program for conclusions coincided in 96.8%. Assessment of interrater agreement showed that level of ratings’ synchronicity increased in the course of material intake, and when using a computer program, the effect was achieved faster and with less probability of errors. Multivariate scaling (Correspondence Analysis of a Two-way Table) showed that the proposed evaluation of images using a computer has indicators identical to TIRADS, a simpler and more understandable lexicon for characterizing signs of thyroid nodes. The results of the application of the program showed higher rates of consistency of experts 'assessments due to the" simplicity " in deciding on the categorization and selection of the most demonstrative features.

Conclusion. Multivariate statistical modeling made it possible to perform an in-depth comparative analysis of systems for the assessment of thyroid gland images. The effectiveness of the proposed domestic computer program for the evaluation of ultrasound images from the standpoint of evidence-based medicine is proved.

1 - I. N. Ulianov Chuvash State University.

2 - Republican clinical oncological dispensary" of the Ministry of health of the Chuvash Republic. Cheboksary, Russia.

3 - Yaroslavl state medical University.

Yaroslavl, Russia.

 

Keywords: thyroid gland, cancer, nodular goiter, ultrasound examination, risk stratification.


Corresponding author:  Timofeeva L.A. e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Timofeeva L.A., Shubin L.B. Expert evaluation of stratification system for nodular thyroid pathology diagnostics. REJR 2019; 9(1):48-56. DOI:10.21569/2222-7415-2019-9-1-48-56.

Received:        05.12.18 Accepted:       16.01.19