Inter-observer variability with five computed tomography severity scales for COVID-19 pneumonia assessment

Area of Science:

• Radiology
• Infectious Diseases
• Pulmonary Medicine

Background:

• The COVID-19 pandemic, caused by a novel coronavirus, emerged in late 2019.
• Computed tomography (CT) is vital for diagnosing COVID-19 pneumonia.
• Standardized assessment of CT findings is essential for patient care.

Purpose of the Study:

• To evaluate inter-observer variability among five distinct scales for quantifying COVID-19 pneumonia severity on CT.
• To identify the most reliable scale for consistent radiological assessment.

Main Methods:

• Analysis of 35 initial chest CT scans from patients with suspected COVID-19 pneumonia.
• Three radiologists independently assessed images using five proposed severity scales.
• Inter-observer agreement calculated using the intra-class correlation index.

Main Results:

• Nearly all patients (77.1%) had five pulmonary lobes affected.
• Scales 1, 2, 4, and 5 exhibited intra-class correlation coefficients greater than 0.91, indicating near-perfect agreement.
• The Wang scale (Scale 4) showed the highest inter-observer agreement (coefficient = 0.964, p = 0.001).

Conclusions:

• The Wang scale offers superior inter-observer reliability for measuring COVID-19 pneumonia extent on CT.
• This scale can enhance diagnostic consistency and improve patient management strategies.
• Further validation of the Wang scale is recommended.