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Aim: To study otoscopy in terms of interobserver and intraobserver agreement, accuracy, sensitivity, specificity, positive and negative predictive value for the diagnosis of otitis media with effusion (OME) in children. Study Design: Cross-sectional study and agreement analysis. Methods: We presented otoscopy images to Otorhinolaryngology specialists and residents and they were instructed to identify the images that corresponded to cases of OME. The same test was repeated 1 month later, with the same images in a different order. We considered that the images were positive for OME whenever the respective tympanogram was type B. Results: Thirty-one otoscopy images and 1240 responses provided by 10 specialist doctors and 10 residents of Otorhinolaryngology were analyzed. Overall mean accuracy was 74.8%. Sensitivity of otoscopy in the diagnose of OME was 81.5% when performed by specialists doctors and 70.0% when performed by residents (p

Objetivo: Avaliar a concordância interobservador entre radiologistas nas categorias diagnósticas de pneumonia intersticial usual (UIP) propostas pela Fleischner Society na tomografia computadorizada (TC) do tórax. Materiais e Métodos: Cinco observadores (quatro especialistas em radiologia torácica e um residente em radiologia), cegados para informações clínicas ou histológicas, categorizaram independentemente TCs de 44 pacientes com suspeita de doença pulmonar intersticial que foram submetidos à biópsia pulmonar no Hospital de Clínicas de Porto Alegre entre janeiro de 2010 e fevereiro de 2019, usando as categorias de diagnóstico para FPI-PIU da Fleischner Society publicadas em 2018 (4 categorias – padrão típico de PIU, PIU provável, indeterminada para PIU e mais consistente com diagnóstico alternativo). Também foram avaliadas a presença, a extensão e a distribuição dos achados de imagem mais relevantes, bem como até três hipóteses diagnósticas e o grau de confiança na hipótese diagnóstica principal. Resultados: Houve moderada a alta concordância interobservador nas categorias diagnósticas para FPI-PIU na TC (k 0,59-0,61) e alta concordância interobservador no escore tomográfico binário (k 0,77-0,79). A concordância interobservador para presença de faveolamento foi considerada alta a muito alta (k 0,69-0,81). Houve concordância em uma das três hipóteses diagnósticas em apenas 36,4% dos casos. Foi encontrada baixa concordância no grau de confiança na hipótese diagnóstica principal (k 0,19-0,21). O padrão tomográfico mais prevalente foi "mais consistente com o diagnóstico alternativo" (variando entre 59% e 63% dos casos entre os leitores). Conclusão: A concordância interobservador para os critérios atuais da Fleischner Society para FPI-PIU na TC se mostrou moderada a alta entre observadores com diferentes níveis de experiência. Houve baixa concordância entre as hipóteses diagnósticas e no grau de confiança da hipótese diagnóstica principal. Purpose: To assess the interobserver agreement among radiologists for the current Fleischner Society criteria for diagnostic categories of usual interstitial pneumonia (UIP) on computed tomography (CT). Methods and materials: Five observers (four thoracic radiologists experts and one radiology resident), blinded to all clinical or histological information, independently categorized CT images of 44 patients with interstitial lung disease who underwent lung biopsy at our institution between January 2010 and February 2019 using the last Fleischner Society diagnostic categories for UIP (4 categories - typical UIP, probable UIP, indeterminate for UIP, and most consistent with non-IPF diagnosis). The presence, extension and distribution of the most relevant imaging findings were also evaluated, as well as the confidence in the most likely diagnosis and in up to three diagnostic hypotheses. Results: There was moderate to high agreement for the diagnostic categories among observers (k 0.59-0.61). Interobserver agreement for the binary score was high (k 0.77-0.79). The interobserver agreement for the presence of honeycomb was considered high to very high (k 0.96-0.81). There was agreement in one of the three diagnostic hypotheses in only 36.4% of the cases. Low agreement for confidence in the most likely diagnosis was found (k 0.19-0.21). The most prevalent CT pattern was “most consistent with non-IPF diagnosis” (ranging from 59% to 63% of the cases among observers). Conclusion: Interobserver agreement for the current Fleischner Society CT criteria for UIP was moderate to high among observers with different levels of experience. There was low agreement on diagnostic hypotheses and for the degree of confidence in the primary diagnosis.

OBJETIVO: Estudar a concordância interobservador na interpretação da superexpressão imuno-histoquímica para a proteína Her2 empregando diferentes anticorpos em array de carcinomas mamários. MATERIAL E MÉTODO: Foi construído um array contendo dois cilindros (2 mm de diâmetro cada) de 25 carcinomas mamários. Cortes histológicos seriados do array foram submetidos à imuno-histoquímica utilizando-se cinco anticorpos anti-Her2: SP3 (NeoMarkers), HercepTest e A0485 (Dako), CB11 (Novocastra) e 4D5 (Genentech). Uma lâmina corada por cada anticorpo (total = cinco lâminas) foi submetida à avaliação individual por cinco observadores seguindo-se o sistema de escore proposto no HercepTestTM. Para a avaliação interobservador os resultados foram interpretados em três diferentes análises: I (0; 1+; 2+; 3+); II (0 e 1+; 2+ e 3+) e III (0 e 1+; 2+; 3+) e aplicado o teste estatístico de kappa. RESULTADOS: A concordância interobservador foi boa quando os casos foram avaliados em quatro categorias (0; 1+; 2+; 3+). Quando avaliados em duas categorias (0 e 1+; 2+ e 3+), a concordância interobservador foi boa para os casos corados por SP3 e CB11 e muito boa para os corados por A0485, HercepTest e 4D5. Na análise III (0 e 1+; 2+; 3+), a concordância interobservador foi considerada moderada para os casos corados por CB11 e boa para os corados pelos outros anticorpos. CONCLUSÃO: A concordância interobservador foi considerada entre moderada e muito boa na avaliação dos cinco anticorpos. A menor concordância interobservador ocorreu nos casos com marcações fraca (1+) e moderada (2+). A experiência dos observadores influenciou as taxas de concordância. AIM: To examine interobserver agreement in immunohistochemical evaluation of Her2 overexpression using five different antibodies on breast cancer array. MATERIAL AND METHOD: Material and method: One array was built with two cores (2 mm diameter each) from 25 breast carcinomas. Serial sections from the array were submitted to immunohistochemistry using five anti-Her2 antibodies: SP3 (NeoMarkers), HercepTest and A0485 (Dako), CB11 (Novocastra), and 4D5 (Genentech). One slide immunostained for each antibody (total = five slides) were independently scored by five observers following HercepTestTM scoring system. Interobserver agreement was evaluated in three different analysis: I (0; 1+; 2+; 3+); II (0 and 1+; 2+ and 3+) and III (0 and 1+; 2+; 3+), and the kappa statistics was applied. RESULTS: There was a good rate of interobserver agreement when the four scores were considered (0; 1+; 2+; 3+). When the scores were considered in two categories (0 and 1+; 2+ and 3+) the interobserver agreement rate was considered substantial for cases stained for SP3 and CB11, and almost perfect for cases stained for A0485, HercepTest and 4D5. For analysis III (0 and 1+; 2+; 3+), a moderate rate of interobserver agreement was considered for cases stained for CB11, and a substantial rate for other antibodies. CONCLUSION: The overall interobserver agreement was considered moderate to substantial in the evaluation of cases stained for the five antibodies. The lowest rate of agreement was obtained in the evaluation of the cases scored as weak (1+) and moderate (2+). The observers experience altered the concordance rates.