Interobserver variation in the detection of pulmonary venous hypertension in chest radiographs

A total of 171 sets of chest radiographs chosen randomly were reviewed independently by two residents in their second year of training, and two experienced radiologists. The degree of interobserver agreement in an overall assessment of pulmonary venous hypertension and in the assessment of five signs, indicative of pulmonary venous hypertension was determined by kappa statistics. The average level of agreement was moderate (0.51-0.56) for the overall assessment and the signs of perivascular clouding, perihilar haze and pleural effusion, and poorer (0.31-0.38) for flow shift and Kerley lines. In the overall assessment agreement between experienced radiologists was slightly better (0.63) than average. Multiple reader interpretation is recommended for the assessment of low-grade pulmonary venous hypertension.