Improving interrater agreement about brain microbleeds: development of the Brain Observer MicroBleed Scale (BOMBS)

Cordonnier, Charlotte, Potter, Gillian M., Jackson, Caroline A., Doubal, Fergus, Keir, Sarah, Sudlow, Cathie L. M., Wardlaw, Joanna M. and Salman, Rustam Al-Shahi (2009) Improving interrater agreement about brain microbleeds: development of the Brain Observer MicroBleed Scale (BOMBS). Stroke, 40 1: 94-99. doi:10.1161/STROKEAHA.108.526996


Author Cordonnier, Charlotte
Potter, Gillian M.
Jackson, Caroline A.
Doubal, Fergus
Keir, Sarah
Sudlow, Cathie L. M.
Wardlaw, Joanna M.
Salman, Rustam Al-Shahi
Title Improving interrater agreement about brain microbleeds: development of the Brain Observer MicroBleed Scale (BOMBS)
Journal name Stroke   Check publisher's open access policy
ISSN 0039-2499
Publication date 2009-01-01
Year available 2008
Sub-type Article (original research)
DOI 10.1161/STROKEAHA.108.526996
Open Access Status Not yet assessed
Volume 40
Issue 1
Start page 94
End page 99
Total pages 6
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams & Wilkins
Language eng
Formatted abstract
Background and Purpose— If the diagnostic and prognostic significance of brain microbleeds (BMBs) are to be investigated and used for these purposes in clinical practice, observer variation in BMB assessment must be minimized.
Methods— Two doctors used a pilot rating scale to describe the number and distribution of BMBs (round, low-signal lesions, <10 mm diameter on gradient echo MRI) among 264 adults with stroke or TIA. They were blinded to clinical data and their counterpart’s ratings. Disagreements were adjudicated by a third observer, who informed the development of a new Brain Observer MicroBleed Scale (BOMBS), which was tested in a separate cohort of 156 adults with stroke.
Results— In the pilot study, agreement about the presence of ≥1 BMB in any location was moderate (κ=0.44; 95% CI, 0.32–0.56), but agreement was worse in lobar locations (κ=0.44; 95% CI, 0.30–0.58) than in deep (κ=0.62; 95% CI, 0.48–0.76) or posterior fossa locations (κ=0.66; 95% CI, 0.47–0.84). Using BOMBS, agreement about the presence of ≥1 BMB improved in any location (κ=0.68; 95% CI, 0.49–0.86) and in lobar locations (κ=0.78; 95% CI, 0.60–0.97).
Conclusion— Interrater reliability concerning the presence of BMBs was moderate to good, and could be improved with the use of the BOMBS rating scale, which takes into account the main sources of interrater disagreement identified by our pilot scale.
Keyword Brain microbleed
Rating scale
Interrater reliability
Classification
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ
Additional Notes Published online before print November 13, 2008

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Public Health Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 127 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 137 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Mon, 19 Mar 2012, 21:10:55 EST by System User on behalf of School of Public Health