Classification of thoracic and lumbar injuries: An analysis of interobserver reliability

1999 ◽  
Vol 28 (8) ◽  
pp. 662-681 ◽  
Author(s):  
M. Blauth ◽  
◽  
L. Bastian ◽  
C. Knop ◽  
U. Lange ◽  
...  
Keyword(s):  
Interobserver Reliability

Treatment Recommendations for Suspected Scapholunate Ligament Pathology

2021 ◽  
Author(s):  
Daniel Bakker ◽  
Joost T.P. Kortlever ◽  
Gerald A. Kraan ◽  
Nina Mathijssen ◽  
Joost W. Colaris ◽  
...  
Keyword(s):  
Interobserver Reliability ◽  
Treatment Recommendations ◽  
Wrist Pain ◽  
Wrist Arthroscopy ◽  
Level Of Evidence ◽  
Interosseous Ligament ◽  
Recent Onset ◽  
Diagnostic Arthroscopy ◽  
Reconstructive Option

Abstract Background The diagnosis and treatment of scapholunate interosseous ligament (SLIL) pathology is debated and notably variable. This study assessed the influence of diagnostic arthroscopy on treatment recommendations and the interobserver reliability of the arthroscopic classification of SLIL pathology. Methods The influence of diagnostic arthroscopy on treatment recommendations and the reliability of the arthroscopic classification of SLIL pathology were tested in a survey-based experiment. Seventy-seven surgeons evaluated 16 scenarios of people with wrist pain with variation in symptoms, scaphoid shift, time of symptom onset, and MRI appearance of the SLIL. Participants were randomized to view or not to view diagnostic wrist arthroscopy. Factors associated with recommendation for repair, capsulodesis, or tenodesis were analyzed. Results Viewing arthroscopic videos was associated with both offering surgery and a more reconstructive option. Other factors independently associated with recommendation for surgery included greater pain intensity and activity intolerance, women surgeons, an asymmetric scaphoid shift, and a recent onset of symptoms. The interobserver reliability of SLIL classification was slight. Conclusions Diagnostic arthroscopy leads to more surgery, and more invasive surgery, in spite of unreliable assessment of pathology. Clinical Relevance This points to the need to measure the potential benefits and harms of diagnostic wrist arthroscopy among people with wrist pain and no clear diagnosis on interview, examination, and radiographs. Level of Evidence Not applicable.

scholarly journals Interobserver reliability of the classification of capitellar osteochondritis dissecans using magnetic resonance imaging

2019 ◽  
Vol 12 (4) ◽  
pp. 284-293 ◽  
Author(s):  
Rens Bexkens ◽  
F. Joseph Simeone ◽  
Denise Eygendaal ◽  
Michel PJ van den Bekerom ◽  
Luke S Oh ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Osteochondritis Dissecans ◽  
Interobserver Agreement ◽  
Interobserver Reliability ◽  
Lateral Wall ◽  
Magnetic Resonance Images ◽  
Resonance Imaging ◽  
Instability Criteria

Aim (1) To determine the interobserver reliability of magnetic resonance classifications and lesion instability criteria for capitellar osteochondritis dissecans lesions and (2) to assess differences in reliability between subgroups. Methods Magnetic resonance images of 20 patients with capitellar osteochondritis dissecans were reviewed by 33 observers, 18 orthopaedic surgeons and 15 musculoskeletal radiologists. Observers were asked to classify the osteochondritis dissecans according to classifications developed by Hepple, Dipaola/Nelson, Itsubo, as well as to apply the lesion instability criteria of DeSmet/Kijowski and Satake. Interobserver agreement was calculated using the multirater kappa (k) coefficient. Results Interobserver agreement ranged from slight to fair: Hepple (k = 0.23); Dipaola/Nelson (k = 0.19); Itsubo (k = 0.18); DeSmet/Kijowksi (k = 0.16); Satake (k = 0.12). When classifications/instability criteria were dichotomized into either a stable or unstable osteochondritis dissecans, there was more agreement for Hepple (k = 0.52; p = .002), Dipaola/Nelson (k = 0.38; p = .015), DeSmet/Kijowski (k = 0.42; p = .001) and Satake (k = 0.41; p < .001). Overall, agreement was not associated with the number of years in practice or the number of osteochondritis dissecans cases encountered per year (p > .05). Conclusion One should be cautious when assigning grades using magnetic resonance classifications for capitellar osteochondritis dissecans. When making treatment decisions, one should rather use relatively simple distinctions (e.g. stable versus unstable osteochondritis dissecans; lateral wall intact versus not intact), as these are more reliable.

scholarly journals Evaluation of Letournel and Judet Classification of Acetabular Fracture with Plain Radiographs and Three-Dimensional Computerized Tomographic Scan

2000 ◽  
Vol 8 (1) ◽  
pp. 33-37 ◽  
Author(s):  
Boonyarak Visutipol ◽  
Pornchai Chobtangsin ◽  
Bunyat Ketmalasiri ◽  
Narongchai Pattarabanjird ◽  
Namchai Varodompun
Keyword(s):  
Ct Scan ◽  
Acetabular Fracture ◽  
Interobserver Reliability ◽  
Three Dimensional ◽  
Fracture Line ◽  
3D Ct ◽  
Plain Radiographs ◽  
Intraobserver Reproducibility ◽  
3D Ct Scan

Letournal and Judet classification of acetabular fracture is widely used. The classification is based on the identification of fracture lines on plain radiographs. Three-dimensional CT scan was claimed to give a better view of the fracture line. Our study showed that intraobserver reproducibility and interobserver reliability were almost the same when classification was done by using plain radiographs and 3D-CT scan. And 3D-CT scan did not increase either the interobserver reliability or the intraobserver reproducibility in classifying the fracture.

scholarly journals Erratum to: AST classification of proximal humeral fractures: introduction and interobserver reliability assessment

2013 ◽  
Vol 23 (3) ◽  
pp. 367-368
Author(s):  
Christian Cuny ◽  
Cedric Baumann ◽  
Julien Mayer ◽  
Didier Guignand ◽  
M’barek Irrazi ◽  
...  
Keyword(s):  
Interobserver Reliability ◽  
Reliability Assessment ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures

scholarly journals Intra and Inter-observer Concordance of a New Classification System for Myopic Maculopathy

2020 ◽  
Author(s):  
Rong-rong Zhang ◽  
Yan Yu ◽  
Yin-fen Hou ◽  
Chang-fan Wu
Keyword(s):  
Classification System ◽  
Clinical Decision Making ◽  
Interobserver Reliability ◽  
Type A ◽  
Clinical Decision ◽  
Intraobserver Agreement ◽  
Intraobserver Reproducibility ◽  
Fundus Photographs ◽  
Myopic Maculopathy

Abstract Background: Myopic maculopathy (MM) is one of the major causes of visual impairment and irreversible blindness in eyes with PM. However, the classification of each type of lesion associated with MM has not been determined. Recently, a new MM classification system was proposed, known as the ATN grading and classification system, which was based on the fundus photographs and OCT images, including three variable components: atrophy (A), traction (T), and neovascularization (N). Hence, this study aimed to perform an independent interobserver and intraobserver agreement evaluation of the recently developed ATN grading system for MM. Methods: This was a retrospective study. Fundus photographs and the optical coherence tomography (OCT) images of 125 patients (226 eyes) with various of MM were evaluated and classified using the ATN grading of the new MM classification system by four evaluators (2 attending ophthalmologists and 2 ophthalmic residents). All cases were repeatedly evaluated by the same evaluators after an interval of 6 weeks. The Kappa coefficient (κ) and 95% confidence interval (CI) were used to determine the interobserver and intraobserver agreement.Results: The interobserver reliability was substantial when considering the maculopathy type (A, T, and N). The weighted Fleiss κ values for each MM type (A, T, and N) were 0.651 (95% CI: 0.602–0.700), 0.734 (95% CI: 0.689–0.779), and 0.702 (95% CI: 0.649–0.755), respectively. The interobserver agreement when considering the sub-types was good or excellent, except for stages A1, A2, and N1 which weighted κ value was less than 0.6, with a moderate agreement. The intraobserver reproducibility of types or sub-types was excellent, with κ>0.8. No significant differences were observed between attending ophthalmologists and residents in the interobserver reliability and intraobserver reproducibility.Conclusions: The ATN classification allows an adequate agreement among ophthalmologists with different qualifications and by the same observer on separate occasions. Future prospective studies should further evaluate whether this classification can be better implemented at clinical decision-making and disease progression assessment.

scholarly journals The interobserver reliability of the diagnosis and classification of scaphoid fractures using high-resolution peripheral quantitative CT

2020 ◽  
Vol 102-B (4) ◽  
pp. 478-484 ◽  
Author(s):  
Anne M. Daniels ◽  
Caroline E. Wyers ◽  
Heinrich M. J. Janzing ◽  
Sander Sassen ◽  
Daan Loeffen ◽  
...  
Keyword(s):  
High Resolution ◽  
Interobserver Agreement ◽  
Interobserver Reliability ◽  
Scaphoid Fracture ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Kappa Statistics ◽  
Quantitative Ct ◽  
Scaphoid Fractures

Aims Besides conventional radiographs, the use of MRI, CT, and bone scintigraphy is frequent in the diagnosis of a fracture of the scaphoid. However, which techniques give the best results remain unknown. The investigation of a new imaging technique initially requires an analysis of its precision. The primary aim of this study was to investigate the interobserver agreement of high-resolution peripheral quantitative CT (HR-pQCT) in the diagnosis of a scaphoid fracture. A secondary aim was to investigate the interobserver agreement for the presence of other fractures and for the classification of scaphoid fracture. Methods Two radiologists and two orthopaedic trauma surgeons evaluated HR-pQCT scans of 31 patients with a clinically-suspected scaphoid fracture. The observers were asked to determine the presence of a scaphoid or other fracture and to classify the scaphoid fracture based on the Herbert classification system. Fleiss kappa statistics were used to calculate the interobserver agreement for the diagnosis of a fracture. Intraclass correlation coefficients (ICCs) were used to assess the agreement for the classification of scaphoid fracture. Results A total of nine (29%) scaphoid fractures and 12 (39%) other fractures were diagnosed in 20 patients (65%) using HR-pQCT across the four observers. The interobserver agreement was 91% for the identification of a scaphoid fracture (95% confidence interval (CI) 0.76 to 1.00) and 80% for other fractures (95% CI 0.72 to 0.87). The mean ICC for the classification of a scaphoid fracture in the seven patients diagnosed with scaphoid fracture by all four observers was 73% (95% CI 0.42 to 0.94). Conclusion We conclude that the diagnosis of scaphoid and other fractures is reliable when using HR-pQCT in patients with a clinically-suspected fracture. Cite this article: Bone Joint J 2020;102-B(4):478–484.

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