{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:21:05Z","timestamp":1786123265239,"version":"build-2736575974"},"reference-count":36,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:00:00Z","timestamp":1775433600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:00:00Z","timestamp":1775433600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp;amp; Neck"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the intra\u2010 and inter\u2010rater reliability of a computer\u2010aided diagnosis system applied to thyroid nodule assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective, single\u2010center study included 150 thyroid nodules evaluated by two physicians at two time points, 90\u2009days apart. Analyses were performed using the AmCAD\u2010UT system, focusing on morphological features and ACR TI\u2010RADS classification. Cohen's kappa coefficient and percentage agreement were used to assess reliability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Intra\u2010rater reliability ranged from moderate to almost perfect, with kappa values from 0.49 (95% CI: 0.31\u20130.66) to 0.98 (95% CI: 0.96\u20131.00), and agreement rates from 81.3% to 99.3%. Rater 2 demonstrated higher reproducibility across most variables, particularly for \u201ctexture\u201d (\n                      <jats:italic>k<\/jats:italic>\n                      \u2009=\u20090.98), \u201cmargin\u201d (\n                      <jats:italic>k<\/jats:italic>\n                      \u2009=\u20090.90), \u201ccomposition\u201d (\n                      <jats:italic>k<\/jats:italic>\n                      \u2009=\u20090.93), and \u201ctaller\u2010than\u2010wide\u201d (\n                      <jats:italic>k<\/jats:italic>\n                      \u2009=\u20090.92). Inter\u2010rater agreement was more variable, with kappa values ranging from 0.43 (95% CI: 0.23\u20130.62) to 0.96 (95% CI: 0.89\u20131.00), and agreement percentages from 78.0% to 99.3%. The lowest inter\u2010rater reproducibility was observed for \u201cshape\u201d.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The computer\u2010aided diagnosis system demonstrated predominantly moderate to almost perfect intra\u2010rater reliability and moderate to strong inter\u2010rater agreement across most evaluated features. The highest reproducibility was observed for \u201ctaller\u2010than\u2010wide,\u201d \u201ctexture,\u201d and \u201ccomposition,\u201d whereas \u201cshape\u201d consistently showed lower agreement. These findings support the system's role as a reliable adjunct for standardizing thyroid nodule assessment, although its performance remains partially influenced by operational factors and warrants further multicenter validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.70264","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T05:24:41Z","timestamp":1775539481000},"page":"2456-2469","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Computer\u2010Aided Diagnosis in the Evaluation of Thyroid Nodules: A Study of Intra\u2010 And Inter\u2010Rater Reliability and Agreement"],"prefix":"10.1002","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6031-8334","authenticated-orcid":false,"given":"Leonardo de Souza","family":"Piber","sequence":"first","affiliation":[{"name":"Evidence\u2010Based Health Universidade Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7996-3269","authenticated-orcid":false,"given":"Luis Carlos Uta","family":"Nakano","sequence":"additional","affiliation":[{"name":"Division of Vascular and Endovascular Surgery, Department of Surgery Universidade Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9943-3583","authenticated-orcid":false,"given":"Carolina Dutra Queiroz","family":"Flumignan","sequence":"additional","affiliation":[{"name":"Discipline of Vascular and Endovascular Surgery Centro Universit\u00e1rio S\u00e3o Camilo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6440-8011","authenticated-orcid":false,"given":"Ronald Luiz Gomes","family":"Flumignan","sequence":"additional","affiliation":[{"name":"Division of Vascular and Endovascular Surgery, Department of Surgery Universidade Federal de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,6]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"AmCad BioMed Corporation \u201cUser's Guide for AmCAD\u2010UT Detection\u2014Version 2.2 [Internet]. 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Taipei Taiwan \u201d2020 http:\/\/www.salusbiomedical.com."},{"key":"e_1_2_9_4_1","unstructured":"U.S. Food & Drug Administration (FDA) \u201c510(k) Premarket Notification K180006: AmCAD\u2010UT Detection 2.2 [Internet] \u201d2018 https:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf18\/K180006.pdf."},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2017.01.046"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2017171240"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcu.23430"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jum.15801"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/9492056"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000016379"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/jum.15802"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics8040069"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.03.002"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000029367"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2015.07.011"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.11613\/BM.2012.031"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jasc.2023.05.005"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010017\u20103919\u20105"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.14366\/usg.20068"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.17.19192"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2020.109050"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2019.0360"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.19.21913"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.840516"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.30347"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.22.27430"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.1018321"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2024.0410"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.media.2023.103039"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/jum.16006"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2016.0372"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11547\u2010018\u20100942\u2010z"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330\u2010018\u20105772\u20109"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2019.05.032"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1109\/ACCESS.2020.3021115"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000020634"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.18.20740"}],"container-title":["Head &amp; Neck"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hed.70264","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hed.70264","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hed.70264","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T14:33:55Z","timestamp":1786113235000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hed.70264"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,6]]},"references-count":36,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/hed.70264"],"URL":"https:\/\/doi.org\/10.1002\/hed.70264","archive":["Portico"],"relation":{},"ISSN":["1043-3074","1097-0347"],"issn-type":[{"value":"1043-3074","type":"print"},{"value":"1097-0347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,6]]},"assertion":[{"value":"2025-09-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}