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Use of "Diagnostic Yield" in Imaging Research Reports: Results from Articles Published in Two General Radiology Journals

  • Ho Young Park (Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Chong Hyun Suh (Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Seon-Ok Kim (Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2022.10.01
  • Accepted : 2022.10.10
  • Published : 2022.12.01

Abstract

Objective: "Diagnostic yield," also referred to as the detection rate, is a parameter positioned between diagnostic accuracy and diagnosis-related patient outcomes in research studies that assess diagnostic tests. Unfamiliarity with the term may lead to incorrect usage and delivery of information. Herein, we evaluate the level of proper use of the term "diagnostic yield" and its related parameters in articles published in Radiology and Korean Journal of Radiology (KJR). Materials and Methods: Potentially relevant articles published since 2012 in these journals were identified using MEDLINE and PubMed Central databases. The initial search yielded 239 articles. We evaluated whether the correct definition and study setting of "diagnostic yield" or "detection rate" were used and whether the articles also reported companion parameters for false-positive results. We calculated the proportion of articles that correctly used these parameters and evaluated whether the proportion increased with time (2012-2016 vs. 2017-2022). Results: Among 39 eligible articles (19 from Radiology and 20 from KJR), 17 (43.6%; 11 from Radiology and 6 from KJR) correctly defined "diagnostic yield" or "detection rate." The remaining 22 articles used "diagnostic yield" or "detection rate" with incorrect meanings such as "diagnostic performance" or "sensitivity." The proportion of correctly used diagnostic terms was higher in the studies published in Radiology than in those published in KJR (57.9% vs. 30.0%). The proportion improved with time in Radiology (33.3% vs. 80.0%), whereas no improvement was observed in KJR over time (33.3% vs. 27.3%). The proportion of studies reporting companion parameters was similar between journals (72.7% vs. 66.7%), and no considerable improvement was observed over time. Conclusion: Overall, a minority of articles accurately used "diagnostic yield" or "detection rate." Incorrect usage of the terms was more frequent without improvement over time in KJR than in Radiology. Therefore, improvements are required in the use and reporting of these parameters.

Keywords

Acknowledgement

This work was supported by the National Research Foundation of Korea (NRF-2021R1C1C1014413 to Chong Hyun Suh).

References

  1. Weinstein S, Obuchowski NA, Lieber ML. Clinical evaluation of diagnostic tests. AJR Am J Roentgenol 2005;184:14-19
  2. Hopewell S, Clarke M, Higgins JPT. Cochrane methods. Cochrane Database Syst Rev 2011;Suppl 1:1-40
  3. Hulley SB, Cummings SR, Browner WS, Grady DG, Newman TB. Designing clinical research, 4th ed. Philadelphia, PA: Lippincott Williams and Wilkins, 2013
  4. Ferrante di Ruffano L, Dinnes J, Sitch AJ, Hyde C, Deeks JJ. Test-treatment RCTs are susceptible to bias: a review of the methodological quality of randomized trials that evaluate diagnostic tests. BMC Med Res Methodol 2017;17:35
  5. Singal AG, Hoshida Y, Pinato DJ, Marrero J, Nault JC, Paradis V, et al. International Liver Cancer Association (ILCA) white paper on biomarker development for hepatocellular carcinoma. Gastroenterology 2021;160:2572-2584
  6. Kim DH, Pickhardt PJ, Taylor AJ, Leung WK, Winter TC, Hinshaw JL, et al. CT colonography versus colonoscopy for the detection of advanced neoplasia. N Engl J Med 2007;357:1403-1412
  7. Tu LH, Malhotra A, Sheth KN, Yaesoubi R, Forman HP, Venkatesh AK. Yield of head computed tomography examinations for common psychiatric presentations and implications for medical clearance from a 6-year analysis of acute hospital visits. JAMA Intern Med 2022;182:879-881
  8. Pepe MS, Etzioni R, Feng Z, Potter JD, Thompson ML, Thornquist M, et al. Phases of biomarker development for early detection of cancer. J Natl Cancer Inst 2001;93:1054-1061
  9. Suh CH, Kim HS, Ahn SS, Seong M, Han K, Park JE, et al. Body CT and PET/CT detection of extracranial lymphoma in patients with newly diagnosed central nervous system lymphoma. Neuro Oncol 2022;24:482-491
  10. Nagayama Y, Inoue T, Oda S, Tanoue S, Nakaura T, Morinaga J, et al. Unenhanced dual-layer spectral-detector CT for characterizing indeterminate adrenal lesions. Radiology 2021;301:369-378
  11. Kim NH, Lee SR, Kim YH, Kim HJ. Diagnostic performance and prognostic relevance of FDG positron emission tomography/computed tomography for patients with extrahepatic cholangiocarcinoma. Korean J Radiol 2020;21:1355-1366
  12. Kumar R, Singh SK, Mittal BR, Vadi SK, Kakkar N, Singh H, et al. Safety and diagnostic yield of 68Ga prostate-specific membrane antigen PET/CT-guided robotic-assisted transgluteal prostatic biopsy. Radiology 2022;303:392-398
  13. Krishnan AP, Song Z, Clayton D, Gaetano L, Jia X, de Crespigny A, et al. Joint MRI T1 unenhancing and contrast-enhancing multiple sclerosis lesion segmentation with deep learning in OPERA trials. Radiology 2022;302:662-673
  14. Yang J, Xie M, Hu C, Alwalid O, Xu Y, Liu J, et al. Deep learning for detecting cerebral aneurysms with CT angiography. Radiology 2021;298:155-163
  15. Zhang M, Milot L, Khalvati F, Sugar L, Downes M, Baig SM, et al. Value of increasing biopsy cores per target with cognitive MRI-targeted transrectal US prostate biopsy. Radiology 2019;291:83-89
  16. Blokker BM, Weustink AC, Wagensveld IM, von der Thusen JH, Pezzato A, Dammers R, et al. Conventional autopsy versus minimally invasive autopsy with postmortem MRI, CT, and CT-guided biopsy: comparison of diagnostic performance. Radiology 2018;289:658-667
  17. Bhatt KM, Tandon YK, Graham R, Lau CT, Lempel JK, Azok JT, et al. Electromagnetic navigational bronchoscopy versus CT-guided percutaneous sampling of peripheral indeterminate pulmonary nodules: a cohort study. Radiology 2018;286:1052-1061
  18. Tan N, Lin WC, Khoshnoodi P, Asvadi NH, Yoshida J, Margolis DJ, et al. In-bore 3-T MR-guided transrectal targeted prostate biopsy: prostate imaging reporting and data system version 2-based diagnostic performance for detection of prostate cancer. Radiology 2017;283:130-139
  19. Kim SY, Chung HW. Small musculoskeletal soft-tissue lesions: US-guided core needle biopsy-comparative study of diagnostic yields according to lesion size. Radiology 2016;278:156-163
  20. Penzkofer T, Tuncali K, Fedorov A, Song SE, Tokuda J, Fennessy FM, et al. Transperineal in-bore 3-T MR imaging-guided prostate biopsy: a prospective clinical observational study. Radiology 2015;274:170-180
  21. Alizai H, Virayavanich W, Joseph GB, Nardo L, Liu F, Liebl H, et al. Cartilage lesion score: comparison of a quantitative assessment score with established semiquantitative MR scoring systems. Radiology 2014;271:479-487
  22. Cornelis F, Rigou G, Le Bras Y, Coutouly X, Hubrecht R, Yacoub M, et al. Real-time contrast-enhanced transrectal US-guided prostate biopsy: diagnostic accuracy in men with previously negative biopsy results and positive MR imaging findings. Radiology 2013;269:159-166
  23. Kim JW, Shin SS, Heo SH, Lim HS, Lim NY, Park YK, et al. The role of three-dimensional multidetector CT gastrography in the preoperative imaging of stomach cancer: emphasis on detection and localization of the tumor. Korean J Radiol 2015;16:80-89
  24. Kim HS, Kwon GY, Kim MJ, Park SY. Prostate imaging-reporting and data system: comparison of the diagnostic performance between version 2.0 and 2.1 for prostatic peripheral zone. Korean J Radiol 2021;22:1100-1109
  25. Lee YH, Baek JH, Jung SL, Kwak JY, Kim JH, Shin JH. Ultrasound-guided fine needle aspiration of thyroid nodules: a consensus statement by the Korean Society of Thyroid Radiology. Korean J Radiol 2015;16:391-401
  26. Niu XK, Bhetuwal A, Yang HF. CT-guided core needle biopsy of pleural lesions: evaluating diagnostic yield and associated complications. Korean J Radiol 2015;16:206-212
  27. Hong W, Yoon SH, Goo JM, Park CM. Cone-beam CT-guided percutaneous transthoracic needle lung biopsy of juxtaphrenic lesions: diagnostic accuracy and complications. Korean J Radiol 2021;22:1203-1212
  28. Venderink W, Jenniskens SF, Michiel Sedelaar JP, Tamada T, Futterer JJ. Yield of repeat targeted direct in-bore magnetic resonance-guided prostate biopsy (MRGB) of the same lesions in men having a prior negative targeted MRGB. Korean J Radiol 2018;19:733-741
  29. Wu EH, Chen YL, Wu YM, Huang YT, Wong HF, Ng SH. CT-guided core needle biopsy of deep suprahyoid head and neck lesions. Korean J Radiol 2013;14:299-306
  30. Jiang B, Li N, Shi X, Zhang S, Li J, de Bock GH, et al. Deep learning reconstruction shows better lung nodule detection for ultra-low-dose chest CT. Radiology 2022;303:202-212
  31. Meltzer C, Vikgren J, Bergman B, Molnar D, Norrlund RR, Hassoun A, et al. Detection and characterization of solid pulmonary nodules at digital chest tomosynthesis: data from a cohort of the pilot Swedish cardiopulmonary bioimage study. Radiology 2018;287:1018-1027
  32. Wang MQ, Duan F, Yuan K, Zhang GD, Yan J, Wang Y. Benign prostatic hyperplasia: cone-beam CT in conjunction with DSA for identifying prostatic arterial anatomy. Radiology 2017;282:271-280
  33. Bertram R, Kaakinen J, Bensch F, Helle L, Lantto E, Niemi P, et al. Eye movements of radiologists reflect expertise in CT study interpretation: a potential tool to measure resident development. Radiology 2016;281:805-815
  34. Potter CA, Fink KR, Ginn AL, Haynor DR. Perimesencephalic hemorrhage: yield of single versus multiple DSA examinations-a single-center study and meta-analysis. Radiology 2016;281:858-864
  35. Burris NS, Johnson KM, Larson PE, Hope MD, Nagle SK, Behr SC, et al. Detection of small pulmonary nodules with ultrashort echo time sequences in oncology patients by using a PET/MR system. Radiology 2016;278:239-246
  36. Rubin GD, Roos JE, Tall M, Harrawood B, Bag S, Ly DL, et al. Characterizing search, recognition, and decision in the detection of lung nodules on CT scans: elucidation with eye tracking. Radiology 2015;274:276-286
  37. Liu D, Fong DY, Chan AC, Poon RT, Khong PL. Hepatocellular carcinoma: surveillance CT schedule after hepatectomy based on risk stratification. Radiology 2015;274:133-140
  38. Lehmkuhl L, Andres C, Lucke C, Hoffmann J, Foldyna B, Grothoff M, et al. Dynamic CT angiography after abdominal aortic endovascular aneurysm repair: influence of enhancement patterns and optimal bolus timing on endoleak detection. Radiology 2013;268:890-899
  39. Jung JY, Yoon YC, Kim HR, Choe BK, Wang JH, Jung JY. Knee derangements: comparison of isotropic 3D fast spin-echo, isotropic 3D balanced fast field-echo, and conventional 2D fast spin-echo MR imaging. Radiology 2013;268:802-813
  40. Ringl H, Stiassny F, Schima W, Toepker M, Czerny C, Schueller G, et al. Intracranial hematomas at a glance: advanced visualization for fast and easy detection. Radiology 2013;267:522-530
  41. Leung AN, Bull TM, Jaeschke R, Lockwood CJ, Boiselle PM, Hurwitz LM, et al. American Thoracic Society documents: an official American Thoracic Society/Society of Thoracic Radiology clinical practice guideline--evaluation of suspected pulmonary embolism in pregnancy. Radiology 2012;262:635-646
  42. Jeon YW, Kim SH, Lee JY, Whang K, Kim MS, Kim YJ, et al. Dynamic CT perfusion imaging for the detection of crossed cerebellar diaschisis in acute ischemic stroke. Korean J Radiol 2012;13:12-19
  43. Lim HJ, Chung MJ, Lee G, Yie M, Shin KE, Moon JW, et al. Interpretation of digital chest radiographs: comparison of light emitting diode versus cold cathode fluorescent lamp backlit monitors. Korean J Radiol 2013;14:968-976
  44. Wang ZL, Miao RL, Gao C, Tang L, Li ZY, Sun YS, et al. Computed tomography arteriography for detecting the origin of the inferior pyloric artery in patients with gastric cancer. Korean J Radiol 2019;20:422-428
  45. Lee S, Ye BD, Park SH, Lee KJ, Kim AY, Lee JS, et al. Diagnostic value of computed tomography in Crohn's disease patients presenting with acute severe lower gastrointestinal bleeding. Korean J Radiol 2018;19:1089-1098
  46. Hong SG, Kang EJ, Park JH, Choi WJ, Lee KN, Kwon HJ, et al. Effect of hybrid kernel and iterative reconstruction on objective and subjective analysis of lung nodule calcification in low-dose chest CT. Korean J Radiol 2018;19:888-896
  47. Choi IY, Park SH, Park SH, Yu CS, Yoon YS, Lee JL, et al. CT enterography for surveillance of anastomotic recurrence within 12 months of bowel resection in patients with Crohn's disease: an observational study using an 8-year registry. Korean J Radiol 2017;18:906-914
  48. Jeon TY, Kim JH, Lee J, Yoo SY, Hwang SM, Lee M. Value of repeat brain MRI in children with focal epilepsy and negative findings on initial MRI. Korean J Radiol 2017;18:729-738
  49. Kim J, Kim YH, Lee KH, Lee YJ, Park JH. Diagnostic performance of CT angiography in patients visiting emergency department with overt gastrointestinal bleeding. Korean J Radiol 2015;16:541-549
  50. Kim DW, Jung SL, Kim J, Ryu JH, Sung JY, Lim HK. Comparison between ultrasonography and computed tomography for detecting the pyramidal lobe of the thyroid gland: a prospective multicenter study. Korean J Radiol 2015;16:402-409
  51. Ding J, Sun G, Lu Y, Yu BB, Li M, Li L, et al. Evaluation of anterior ethmoidal artery by 320-slice CT angiography with comparison to three-dimensional spin digital subtraction angiography: initial experiences. Korean J Radiol 2012;13:667-673
  52. Kim S, Seo K, Song HT, Suh JS, Yoon CS, Ryu JA, et al. Determination of optimal imaging mode for ultrasonographic detection of subdermal contraceptive rods: comparison of spatial compound, conventional, and tissue harmonic imaging methods. Korean J Radiol 2012;13:602-609
  53. Chung SY, Park SH, Lee SS, Lee JH, Kim AY, Park SK, et al. Comparison between CT colonography and double-contrast barium enema for colonic evaluation in patients with renal insufficiency. Korean J Radiol 2012;13:290-299
  54. Youn SY, Kim DH, Choi JI, Choi MH, Kim B, Shin YR, et al. Usefulness of arterial subtraction in applying liver imaging reporting and data system (LI-RADS) treatment response algorithm to gadoxetic acid-enhanced MRI. Korean J Radiol 2021;22:1289-1299
  55. Ahn D, Lee GJ, Sohn JH, Lee JE. Percutaneous ultrasound-guided fine-needle aspiration cytology and core-needle biopsy for laryngeal and hypopharyngeal masses. Korean J Radiol 2021;22:596-603
  56. Shin JM, Choi EY, Park CH, Han K, Kim TH. Quantitative T1 mapping for detecting microvascular obstruction in reperfused acute myocardial infarction: comparison with late gadolinium enhancement imaging. Korean J Radiol 2020;21:978-986
  57. Weikert T, Noordtzij LA, Bremerich J, Stieltjes B, Parmar V, Cyriac J, et al. Assessment of a deep learning algorithm for the detection of rib fractures on whole-body trauma computed tomography. Korean J Radiol 2020;21:891-899
  58. Nam JG, Lee JM, Lee SM, Kang HJ, Lee ES, Hur BY, et al. High acceleration three-dimensional T1-weighted dual echo Dixon hepatobiliary phase imaging using compressed sensing-sensitivity encoding: comparison of image quality and solid lesion detectability with the standard T1-weighted sequence. Korean J Radiol 2019;20:438-448
  59. Schwenzer NF, Seith F, Gatidis S, Brendle C, Schmidt H, Pfannenberg CA, et al. Diagnosing lung nodules on oncologic MR/PET imaging: comparison of fast T1-weighted sequences and influence of image acquisition in inspiration and expiration breath-hold. Korean J Radiol 2016;17:684-694
  60. Yoon HJ, Chung MJ, Hwang HS, Moon JW, Lee KS. Adaptive statistical iterative reconstruction-applied ultra-low-dose CT with radiography-comparable radiation dose: usefulness for lung nodule detection. Korean J Radiol 2015;16:1132-1141
  61. Jung SI, Park HS, Yim Y, Jeon HJ, Yu MH, Kim YJ, et al. Added value of using a CT coronal reformation to diagnose adnexal torsion. Korean J Radiol 2015;16:835-845
  62. Jung SI, Park HS, Kim YJ, Jeon HJ. Multidetector computed tomography for the assessment of adnexal mass: is unenhanced CT scan necessary? Korean J Radiol 2014;15:72-79
  63. Metser U, Zukotynski K, Mak V, Langer D, MacCrostie P, Finelli A, et al. Effect of 18F-DCFPyL PET/CT on the management of patients with recurrent prostate cancer: results of a prospective multicenter registry trial. Radiology 2022;303:414-422
  64. Hwang EJ, Lee JS, Lee JH, Lim WH, Kim JH, Choi KS, et al. Deep learning for detection of pulmonary metastasis on chest radiographs. Radiology 2021;301:455-463
  65. Kim M, Suh CH, Lee SM, Kim HC, Aizer AA, Yanagihara TK, et al. Diagnostic yield of staging brain MRI in patients with newly diagnosed non-small cell lung cancer. Radiology 2020;297:419-427
  66. Park JH, Park MS, Lee SJ, Jeong WK, Lee JY, Park MJ, et al. Contrast-enhanced US with perfluorobutane for hepatocellular carcinoma surveillance: a multicenter diagnostic trial (SCAN). Radiology 2019;292:638-646
  67. Suh CH, Kim HS, Park JE, Jung SC, Choi CG, Kim SJ. Primary central nervous system lymphoma: diagnostic yield of whole-body CT and FDG PET/CT for initial systemic imaging. Radiology 2019;292:440-446
  68. Lee KH, Park JH, Kim YH, Lee KW, Kim JW, Oh HK, et al. Diagnostic yield and false-referral rate of staging chest CT in patients with colon cancer. Radiology 2018;289:535-545
  69. Kavanagh J, Liu G, Menezes R, O'Kane GM, McGregor M, Tsao M, et al. Importance of long-term low-dose CT follow-up after negative findings at previous lung cancer screening. Radiology 2018;289:218-224
  70. Brehmer K, Brismar TB, Morsbach F, Svensson A, Stal P, Tzortzakakis A, et al. Triple arterial phase CT of the liver with radiation dose equivalent to that of single arterial phase CT: initial experience. Radiology 2018;289:111-118
  71. Kuhl CK, Bruhn R, Kramer N, Nebelung S, Heidenreich A, Schrading S. Abbreviated biparametric prostate MR imaging in men with elevated prostate-specific antigen. Radiology 2017;285:493-505
  72. Haste AK, Brewer BL, Steenburg SD. Diagnostic yield and clinical utility of abdominopelvic CT following emergent laparotomy for trauma. Radiology 2016;280:735-742
  73. Harvey HB, Gilman MD, Wu CC, Cushing MS, Halpern EF, Zhao J, et al. Diagnostic yield of recommendations for chest CT examination prompted by outpatient chest radiographic findings. Radiology 2015;275:262-271
  74. Schafer JF, Gatidis S, Schmidt H, Guckel B, Bezrukov I, Pfannenberg CA, et al. Simultaneous whole-body PET/MR imaging in comparison to PET/CT in pediatric oncology: initial results. Radiology 2014;273:220-231
  75. Toth DF, Topker M, Mayerhofer ME, Rubin GD, Furtner J, Asenbaum U, et al. Rapid detection of bone metastasis at thoracoabdominal CT: accuracy and efficiency of a new visualization algorithm. Radiology 2014;270:825-833
  76. Kim S, Yang KH, Lim H, Lee YK, Yoon HK, Oh CW, et al. Detection of prefracture hip lesions in atypical subtrochanteric fracture with dual-energy X-ray absorptiometry images. Radiology 2014;270:487-495
  77. Pooler BD, Kim DH, Hassan C, Rinaldi A, Burnside ES, Pickhardt PJ. Variation in diagnostic performance among radiologists at screening CT colonography. Radiology 2013;268:127-134
  78. Mangold S, Thomas C, Fenchel M, Vuust M, Krauss B, Ketelsen D, et al. Virtual nonenhanced dual-energy CT urography with tin-filter technology: determinants of detection of urinary calculi in the renal collecting system. Radiology 2012;264:119-125
  79. Metser U, Goldstein MA, Chawla TP, Fleshner NE, Jacks LM, O'Malley ME. Detection of urothelial tumors: comparison of urothelial phase with excretory phase CT urography--a prospective study. Radiology 2012;264:110-118
  80. Wang Y, van Klaveren RJ, de Bock GH, Zhao Y, Vernhout R, Leusveld A, et al. No benefit for consensus double reading at baseline screening for lung cancer with the use of semiautomated volumetry software. Radiology 2012;262:320-326
  81. Park SH, Choi J, Byeon JS. Key principles of clinical validation, device approval, and insurance coverage decisions of artificial intelligence. Korean J Radiol 2021;22:442-453
  82. Henrikson NB, Aiello Bowles EJ, Blasi PR, Morrison CC, Nguyen M, Pillarisetty VG, et al. Screening for pancreatic cancer: updated evidence report and systematic review for the US Preventive services task force. JAMA 2019;322:445-454
  83. Berg WA, Blume JD, Cormack JB, Mendelson EB, Lehrer D, Bohm-Velez M, et al. Combined screening with ultrasound and mammography vs mammography alone in women at elevated risk of breast cancer. JAMA 2008;299:2151-2163