Common use of Statistical Analyses Clause in Contracts

Statistical Analyses. The concordance rates for responses to the clinical questions raised by the referring physicians, clinically pertinent findings, incidental findings, and proposed investigations were tabulated to in 88.1% of cases (95% CI, 80.6%–92.9%). The ▇▇▇▇▇ n for pos- itive studies was 0.86 (0.77– 0.95) and 0.59 (0.45– 0.74) for the presence/absence of any clinically pertinent findings and for inci- dental findings, respectively. Readings were in agreement for 75.6% (67.2%– 82.5%), 65.5% (56.6%–73.5%), and 86.6% (79.2%–91.6%) of clinically pertinent findings, incidental findings, and recommendations for further in- vestigations, respectively (Table 1). Rates were similar for the 2 sub- groups (referred from the neuro-oncology clinic or from all other clinics). Class 2 discrepancies in reporting clinically pertinent findings were found in 18 cases (15.1%). They are summarized in Table 2. Examples include the presence or absence of a tumor recurrence FIG 2. Class 2 discrepancies in incidental findings. A, One reader reported a polypoid posterior nasal lesion (arrow), whereas the other observer did not mention this incidental finding. B, A pineal cyst (circle) was mentioned in only 1 of the 2 reports. independent observers. Their study showed agreement in 51%, 61%, and 74% of abdominal, chest, and skeletal x-rays, respectively. They also assessed performance by calculating n statistics of interobserver agreement. Weighted n values between pairs of observers were higher with skeletal (0.76 – 0.77) than with chest (0.63– 0.68) or abdominal (0.50 – 0.78) examinations. In a meta- analysis conducted by ▇▇ et al,2 the global discrepancy rate was 7.7% (in- cluding a major discrepancy rate of 2.4%). The major discrepancy rate var- ied according to body region: It was lower for head (0.8%) and spine CT (0.7%) than chest (2.8%) and abdomi- nal CT (2.6%). Blinding of the reference (n = 4, Fig 1A), the growth of a meningioma (n = 2), the evolu- tion of chronic subdural hematomas (n = 2), and the presence of a lytic bone lesion (Fig 1B). These discrepancies were normally distributed between readers (n = 1, 3, 5, 7, 11, 5, 3, 1 for 36 discrepant reports). There was no significant difference between contrast-enhanced (n = 9 of 53) and nonenhanced studies (n = 9 of 66, P = .62). Class 1 discrepancies in clinically pertinent findings were seen in the interpretation of 11 cases. Examples include the location of recent ischemic lesions (n = 2), tumor extensions (n = 2), or the disconnection of a ventricular shunt (n = 1). Class 2 discrepancies in reporting incidental findings were seen in 35 cases. Examples include the presence or absence of white matter disease (n = 10), chronic sinusitis (n = 6), old strokes (n = 5), atrophy (n = 4), a nasal polyp (Fig 2A), or a pineal cyst (Fig 2B). Class 1 discrepancies in calling incidental findings were seen in 6 cases. Examples include the location of lacunar infarcts (n = 2) or the extension of chronic sinusitis (n = 2). The senior author confirmed the discrepancies identified by the first adjudicator in all cases, except for 2 minor modifications in the categorization of incidental findings.

Statistical Analyses. The concordance rates for responses to the clinical questions raised by the referring physicians, clinically pertinent findings, incidental findings, and proposed investigations were tabulated to in 88.1% of cases (95% CI, 80.6%–92.9%). The ▇▇▇▇▇ n for pos- itive studies was 0.86 (0.77– 0.95) and 0.59 (0.45– 0.74) for the presence/absence of any clinically pertinent findings and for inci- dental findings, respectively. Readings were in agreement for 75.6% (67.2%– 82.5%), 65.5% (56.6%–73.5%), and 86.6% (79.2%–91.6%) of clinically pertinent findings, incidental findings, and recommendations for further in- vestigations, respectively (Table 1). Rates were similar for the 2 sub- groups (referred from the neuro-oncology clinic or from all other clinics). Class 2 discrepancies in reporting clinically pertinent findings were found in 18 cases (15.1%). They are summarized in Table 2. Examples include the presence or absence of a tumor recurrence FIG 2. Class 2 discrepancies in incidental findingsfindings. A, One reader reported a polypoid posterior nasal lesion (arrow), whereas the other observer did not mention this incidental findingfinding. B, A pineal cyst (circle) was mentioned in only 1 of the 2 reports. independent observers. Their study showed agreement in 51%, 61%, and 74% of abdominal, chest, and skeletal x-rays, respectively. They also assessed performance by calculating n statistics of interobserver agreement. Weighted n values between pairs of observers were higher with skeletal (0.76 – 0.77) than with chest (0.63– 0.68) or abdominal (0.50 – 0.78) examinations. In a meta- analysis conducted by ▇▇ et al,2 the global discrepancy rate was 7.7% (in- cluding a major discrepancy rate of 2.4%). The major discrepancy rate var- ied according to body region: It was lower for head (0.8%) and spine CT (0.7%) than chest (2.8%) and abdomi- nal CT (2.6%). Blinding of the reference (n = 4, Fig 1A), the growth of a meningioma (n = 2), the evolu- tion of chronic subdural hematomas (n = 2), and the presence of a lytic bone lesion (Fig 1B). These discrepancies were normally distributed between readers (n = 1, 3, 5, 7, 11, 5, 3, 1 for 36 discrepant reports). There was no significant difference between contrast-enhanced (n = 9 of 53) and nonenhanced studies (n = 9 of 66, P = .62). Class 1 discrepancies in clinically pertinent findings were seen in the interpretation of 11 cases. Examples include the location of recent ischemic lesions (n = 2), tumor extensions (n = 2), or the disconnection of a ventricular shunt (n = 1). Class 2 discrepancies in reporting incidental findings were seen in 35 cases. Examples include the presence or absence of white matter disease (n = 10), chronic sinusitis (n = 6), old strokes (n = 5), atrophy (n = 4), a nasal polyp (Fig 2A), or a pineal cyst (Fig 2B). Class 1 discrepancies in calling incidental findings were seen in 6 cases. Examples include the location of lacunar infarcts (n = 2) or the extension of chronic sinusitis (n = 2). The senior author confirmed the discrepancies identified by the first adjudicator in all cases, except for 2 minor modifications in the categorization of incidental findings.