Development and assessment of the AE-RADS standardized grid for specifically evaluating adverse events in diagnostic radiology and teleradiology

Abstract Background A specific grid for analyzing and grading adverse events in diagnostic radiology is lacking. In France, the standard HAS grid, a generic 5-point scale adapted from the Common Terminology Criteria for Adverse Events (CTCAEs), is criticized for limited applicability in radiology. O...

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Main Authors: Jean-François Bergerot, Amandine Crombé, Mylène Seux, Basile Porta, Vanessa Fyon, Samuel Le Nivet, Nicolas Lippa, Rémi Peyre, Paul Etchart, Frédérique Gay, Guillaume Gorincour
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Language:English
Published: BMC 2025-05-01
Series:BMC Medical Imaging
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Online Access:https://doi.org/10.1186/s12880-025-01670-9
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author Jean-François Bergerot
Amandine Crombé
Mylène Seux
Basile Porta
Vanessa Fyon
Samuel Le Nivet
Nicolas Lippa
Rémi Peyre
Paul Etchart
Frédérique Gay
Guillaume Gorincour
author_facet Jean-François Bergerot
Amandine Crombé
Mylène Seux
Basile Porta
Vanessa Fyon
Samuel Le Nivet
Nicolas Lippa
Rémi Peyre
Paul Etchart
Frédérique Gay
Guillaume Gorincour
author_sort Jean-François Bergerot
collection DOAJ
description Abstract Background A specific grid for analyzing and grading adverse events in diagnostic radiology is lacking. In France, the standard HAS grid, a generic 5-point scale adapted from the Common Terminology Criteria for Adverse Events (CTCAEs), is criticized for limited applicability in radiology. Our aim was to develop and evaluate a radiology-specific AE grid (AE-RADS) tailored to diagnostic and teleradiological practices and to compare its performance against the CTCAEs-based HAS grid regarding inter-observer reproducibility and agreement with expert consensus. Methods AE-RADS, structured as a decision tree with 90 items, was developed by four senior radiologists with extensive AE experience. To assess it, 100 AE cases from early 2022 were reviewed by two radiologists and two non-physician support members, all blinded to the initial AE grading. Observers rated AEs using both the HAS and AE-RADS grids, comparing severity, AE frequency per patient, sources, and types for inter-observer reproducibility and expert agreement. Tests included intra-class correlation coefficient (ICC), Fleiss Kappa and Krippendorff alpha for reproducibility and McNemar test for comparing agreement with consensus. Results Among 100 patients (49 women, median age 66.9 years), 104 AEs were identified. AE-RADS achieved higher inter-observer reproducibility for AE frequency (ICC = 0.690 vs. 0.642 with HAS) and for grading the most serious AE (Krippendorff alpha = 0.519 vs. 0.506 with HAS). Agreement with expert consensus was significantly greater with AE-RADS (63–81%) than with HAS (25–47%; P-value range: 0.0001–0.0051). Conclusion AE-RADS shows improved, though still imperfect, agreement between evaluators and experts, supporting its potential for more precise AE assessment in diagnostic imaging.
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spelling doaj-art-26903eead6534bba8cf4f46f76acae7c2025-08-20T02:10:54ZengBMCBMC Medical Imaging1471-23422025-05-0125111610.1186/s12880-025-01670-9Development and assessment of the AE-RADS standardized grid for specifically evaluating adverse events in diagnostic radiology and teleradiologyJean-François Bergerot0Amandine Crombé1Mylène Seux2Basile Porta3Vanessa Fyon4Samuel Le Nivet5Nicolas Lippa6Rémi Peyre7Paul Etchart8Frédérique Gay9Guillaume Gorincour10IMADIS GroupeIMADIS GroupeIMADIS GroupeIMADIS GroupeIMADIS GroupeIMADIS GroupeIMADIS GroupeIMADIS GroupeIMADIS GroupeIMADIS GroupeIMADIS GroupeAbstract Background A specific grid for analyzing and grading adverse events in diagnostic radiology is lacking. In France, the standard HAS grid, a generic 5-point scale adapted from the Common Terminology Criteria for Adverse Events (CTCAEs), is criticized for limited applicability in radiology. Our aim was to develop and evaluate a radiology-specific AE grid (AE-RADS) tailored to diagnostic and teleradiological practices and to compare its performance against the CTCAEs-based HAS grid regarding inter-observer reproducibility and agreement with expert consensus. Methods AE-RADS, structured as a decision tree with 90 items, was developed by four senior radiologists with extensive AE experience. To assess it, 100 AE cases from early 2022 were reviewed by two radiologists and two non-physician support members, all blinded to the initial AE grading. Observers rated AEs using both the HAS and AE-RADS grids, comparing severity, AE frequency per patient, sources, and types for inter-observer reproducibility and expert agreement. Tests included intra-class correlation coefficient (ICC), Fleiss Kappa and Krippendorff alpha for reproducibility and McNemar test for comparing agreement with consensus. Results Among 100 patients (49 women, median age 66.9 years), 104 AEs were identified. AE-RADS achieved higher inter-observer reproducibility for AE frequency (ICC = 0.690 vs. 0.642 with HAS) and for grading the most serious AE (Krippendorff alpha = 0.519 vs. 0.506 with HAS). Agreement with expert consensus was significantly greater with AE-RADS (63–81%) than with HAS (25–47%; P-value range: 0.0001–0.0051). Conclusion AE-RADS shows improved, though still imperfect, agreement between evaluators and experts, supporting its potential for more precise AE assessment in diagnostic imaging.https://doi.org/10.1186/s12880-025-01670-9Adverse eventsTeleradiologyRadiologyHealthcare evaluationManagement by quality
spellingShingle Jean-François Bergerot
Amandine Crombé
Mylène Seux
Basile Porta
Vanessa Fyon
Samuel Le Nivet
Nicolas Lippa
Rémi Peyre
Paul Etchart
Frédérique Gay
Guillaume Gorincour
Development and assessment of the AE-RADS standardized grid for specifically evaluating adverse events in diagnostic radiology and teleradiology
BMC Medical Imaging
Adverse events
Teleradiology
Radiology
Healthcare evaluation
Management by quality
title Development and assessment of the AE-RADS standardized grid for specifically evaluating adverse events in diagnostic radiology and teleradiology
title_full Development and assessment of the AE-RADS standardized grid for specifically evaluating adverse events in diagnostic radiology and teleradiology
title_fullStr Development and assessment of the AE-RADS standardized grid for specifically evaluating adverse events in diagnostic radiology and teleradiology
title_full_unstemmed Development and assessment of the AE-RADS standardized grid for specifically evaluating adverse events in diagnostic radiology and teleradiology
title_short Development and assessment of the AE-RADS standardized grid for specifically evaluating adverse events in diagnostic radiology and teleradiology
title_sort development and assessment of the ae rads standardized grid for specifically evaluating adverse events in diagnostic radiology and teleradiology
topic Adverse events
Teleradiology
Radiology
Healthcare evaluation
Management by quality
url https://doi.org/10.1186/s12880-025-01670-9
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