To: scaram(o)uche who wrote (1814 ) 10/16/2000 9:51:39 PM From: scaram(o)uche Read Replies (2) | Respond to I've read it now.Of the 32 subjects whose scar score changed, the magnitude of the change was 1 unit in 26 cases (greater than 80%). In only 4 cases was the magnitude of the change 2 units, and in only 2 cases was the magnitude of change 3 units. In 1 of the 2 cases in which the magnitude of change was 3 units, the patient [*] was considered non-evaluable for other reasons, and not included in the final analysis. In summary, the individual changes in max scar score appeared small in magnitude in the majority of cases and would not be unexpected for a subjective measurement. Of the 27 patients included in the final analysis (16 ADCON-L and 11 Control), fifteen of sixteen ADCON-L patients had maximum scar scores showing scar improvement, and nine of eleven control patients had maximum scar scores showing scar worsening. Although the kappa scores indicate a high degree of reliability in reading the MRI, these observed changes are not surprising. One probable reason for differences in the assessment of scar in the intraobserver reliability study was that the multiple MRI reads (~60 MRIs) were done during each of the two defined sessions. This would lend itself to a greater consistency in scoring when compared to reading over a longer period of time (approximately 2 yrs) and with limited samples at each read. The conditions of the reading session would be expected to influence the variability of the neuroradiologist. An improvement in reader consistency would tend to favor a more accurate reading and would establish treatment differences that may be missed under less stringent conditions. The improved consistency would also be particularly important in measurements in which ranges of scar are being determined (i.e., 0-25%, 26-50%, 51-75%, 76-100% scar within the quadrant of each MRI slice).
