A Reliability Study of Multiplanar Radiographs for the Evaluation of SNAC Wrist Arthritis

Hand ◽  
2020 ◽  
pp. 155894472093735
Author(s):  
Eliana B. Saltzman ◽  
Elizabeth P. Wahl ◽  
Amanda N. Fletcher ◽  
Nicholas Said ◽  
Suhail K. Mithani ◽  
...  

Background: Scaphoid nonunion advanced collapse (SNAC) is a common form of wrist arthritis, the treatment of which depends on the arthritic stage. The Vender classification serves to describe SNAC arthritis based on a single posteroanterior (PA) radiograph. The purpose of this study was to evaluate the intraobserver and interobserver agreement of the Vender classification, comparing multi versus single radiographic views. Methods: A retrospective review of patients with SNAC arthritis who underwent a proximal row carpectomy or a 4-corner fusion was performed. The included patients had 3 radiographic views of the pathologic wrist. Fifteen patients were analyzed by 5 blinded reviewers. Wrists were graded using the Vender classification first on the PA view and then using multiview radiographs. The intraobserver and interobserver agreement was determined using weighted kappa analysis. χ2 tests were calculated comparing the evaluation between single- versus multiview radiographs and determining a higher Vender stage. Results: Multiview radiographs demonstrated a higher intraobserver κw compared with single-view radiographs (0.72 vs 0.66), both representing substantial agreement. The average interobserver agreement was moderate (κw of 0.48) for single view and slight (κw of 0.30) for multiview evaluation. Evaluating multiview radiographs was 6.37 times more likely to demonstrate Vender stage 3 arthritis compared with single view (odds ratio = 6.37 [confidence interval, 3.81-10.64], P < .0001). Conclusion: Reviewing multiview radiographs more commonly yielded Vender stage 3 osteoarthritis classification. The decreased interrater reliability in the multiview analysis is likely related to the increased number of articular surfaces evaluated. Using a single PA view may underestimate the severity of arthritis present.

2011 ◽  
Vol 199 (2) ◽  
pp. 151-155 ◽  
Author(s):  
James Rucker ◽  
Stuart Newman ◽  
Joanna Gray ◽  
Cerisse Gunasinghe ◽  
Matthew Broadbent ◽  
...  

BackgroundThe increasingly large sample size requirements of modern adult mental health research suggests the need for a data collection and diagnostic application that can be used across a broad range of clinical and research populations.AimsTo develop a data collection and diagnostic application that can be used across a broad range of clinical and research settings.MethodWe expanded and redeveloped the OPCRIT system into a broadly applicable diagnostic and data-collection package and carried out an interrater reliability study of this new tool.ResultsOPCRIT+ performed well in an interrater reliability study with relatively inexperienced clinicians, giving a combined, weighted kappa of 0.70 for diagnostic reliability.ConclusionsOPCRIT+ showed good overall interrater reliability scores for diagnoses. It is now incorporated in the electronic patient record of the Maudsley and associated hospitals. OPCRIT+ can be downloaded free of charge at http://sgdp.iop.kcl.ac.uk/opcritplus.


1986 ◽  
Vol 11 (2) ◽  
pp. 255-257
Author(s):  
S. S. KRISTENSEN ◽  
E. THOMASSEN ◽  
F. CHRISTENSEN

Surgical procedures concerning the distal articular surfaces of the radius and ulna, demand an accurate method of measurement of ulnar variance. A new method, which is a modification of the method described by Palmer (1982), is introduced. 100 randomly selected healthy persons were submitted to X-ray of the wrist and the ulnar variance was determined independently by three observers using both methods. By “weighted kappa” statistics the results, expressed in intra- and interobserver agreement, showed a significantly higher reliability in favour of the Modified method.


2020 ◽  
Vol 25 (1) ◽  
pp. 37-42 ◽  
Author(s):  
Ros Whelan ◽  
Eric Prince ◽  
David M. Mirsky ◽  
Robert Naftel ◽  
Aashim Bhatia ◽  
...  

OBJECTIVEPediatric adamantinomatous craniopharyngiomas (ACPs) are histologically benign brain tumors that confer significant neuroendocrine morbidity. Previous studies have demonstrated that injury to the hypothalamus is associated with worsened quality of life and a shorter lifespan. This insight helps many surgeons define the goals of surgery for patients with ACP. Puget and colleagues proposed a 3-tiered preoperative and postoperative grading system based on the degree of hypothalamic involvement identified on MRI. In a prospective cohort from their institution, the authors found that use of the system to guide operative goals was associated with decreased morbidity. To date, however, the Puget system has not been externally validated. Here, the authors present an interrater reliability study that assesses the generalizability of this system for surgeons planning initial operative intervention for children with craniopharyngiomas.METHODSA panel of 6 experts, consisting of pediatric neurosurgeons and pediatric neuroradiologists, graded 30 preoperative and postoperative MRI scans according to the Puget system. Interrater reliability was calculated using Fleiss’ κ and Krippendorff’s α statistics.RESULTSInterrater reliability in the preoperative context demonstrated moderate agreement (κ = 0.50, α = 0.51). Interrater reliability in the postoperative context was 0.27 for both methods of statistical evaluation.CONCLUSIONSInterrater reliability for the system as defined is moderate. Slight refinements of the Puget MRI grading system, such as collapsing the 3 grades into 2, may improve its reliability, making the system more generalizable.


2015 ◽  
Vol 10 (2) ◽  
pp. 183-190 ◽  
Author(s):  
Joel B. Chidley ◽  
Alexandra L. MacGregor ◽  
Caoimhe Martin ◽  
Calum A. Arthur ◽  
Jamie H. Macdonald

Purpose:To identify physiological, psychological, and skill characteristics that explain performance in downhill (DH) mountainbike racing.Methods:Four studies were used to (1) identify factors potentially contributing to DH performance (using an expert focus group), (2) develop and validate a measure of rider skill (using video analysis and expert judge evaluation), (3) evaluate whether physiological, psychological, and skill variables contribute to performance at a DH competition, and (4) test the specific contribution of aerobic capacity to DH performance.Results:Study 1 identified aerobic capacity, handgrip endurance, anaerobic power, rider skill, and self-confidence as potentially important for DH. In study 2 the rider-skill measure displayed good interrater reliability. Study 3 found that rider skill and handgrip endurance were significantly related to DH ride time (β = –0.76 and –0.14, respectively; R2 = .73), with exploratory analyses suggesting that DH ride time may also be influenced by self-confidence and aerobic capacity. Study 4 confirmed aerobic capacity as an important variable influencing DH performance (for a DH ride, mean oxygen uptake was 49 ± 5 mL · kg−1 · min−1, and 90% of the ride was completed above the 1st ventilatory threshold).Conclusions:In order of importance, rider skill, handgrip endurance, self-confidence, and aerobic capacity were identified as variables influencing DH performance. Practically, this study provides a novel assessment of rider skill that could be used by coaches to monitor training and identify talent. Novel intervention targets to enhance DH performance were also identified, including self-confidence and aerobic capacity.


2016 ◽  
Vol 21 (01) ◽  
pp. 24-29 ◽  
Author(s):  
Younis Kamal ◽  
Hayat Ahmad Khan ◽  
Naseem UI Gani ◽  
Munir Farooq ◽  
Adil Bashir Shah ◽  
...  

Background: The purpose of this study is to test the hypothesis of the new classification system of distal end radius fractures (Barzullah working classification) proposed by one of the author in a prospective cohort study, among the orthopaedic residents. Methods: The initial post-injury radiographs of 300 patients with distal radius fractures in a tertiary centre were classified by two junior residents (JR1 and JR2) and two senior residents (SR1 and SR2) in the emergency department over a period of two years. The collected data was analysed statistically by using Cohan's kappa for measuring Intraobserver reproducibility and Fleiss kappa for measuring Interobserver agreement. Results: The mean kappa value for Interobserver agreement was 0.53 (moderate agreement) at the end of one year and the mean kappa value at the end of study period was 0.64 (substantial agreement). The mean kappa value for Intraobserver reproducibility of JR1 was 0.45 (moderate agreement), JR2 was 0.39 (fair agreement), SR1 was 0.62 (substantial agreement) and SR2 was 0.67 (substantial agreement). Conclusions: Barzullah working classification of distal radius fractures presented in this study has good characteristics compared to those of already studied classification systems among orthopaedic residents.


2020 ◽  
Vol 100 (3) ◽  
pp. 468-476 ◽  
Author(s):  
Bolette S Rafn ◽  
Chiara A Singh ◽  
Julie Midtgaard ◽  
Pat G Camp ◽  
Margaret L McNeely ◽  
...  

Abstract Background Early identification of breast cancer–related upper body issues is important to enable timely physical therapist treatment. Objective This study evaluated the feasibility and reliability of women performing self-managed prospective surveillance for upper body issues in the early postoperative phase as part of a hospital-based physical therapy program. Design This was a prospective, single-site, single-group feasibility and reliability study. Methods Presurgery arm circumference measurements were completed at home and at the hospital by participants and by a physical therapist. Instruction in self-measurement was provided using a video guide. After surgery, all circumference measurements were repeated along with self-assessment and therapist assessment for shoulder flexion and abduction active range of motion. Feasibility was determined by recruitment/retention rates and participant-reported ease of performing self-measurements (1 [very difficult] to 10 [very easy]). Reliability was determined as intrarater reliability, interrater reliability, and agreement. Results Thirty-three women who were 53.4 (SD = 11.4) years old participated, with recruitment and retention rates of 79% and 94%, respectively. Participant-reported ease of measurement was 8.2 (SD = 2.2) before surgery and 8.0 (SD = 1.9) after surgery. The intrarater reliability and interrater reliability were excellent before surgery (intraclass correlation coefficient [ICC] ≥ 0.94; 95% confidence interval = 0.87–0.97) and after surgery (ICC ≥ 0.91; 95% confidence interval = 0.76–0.96). Agreement between self-assessed and therapist-assessed active shoulder flexion (κ = 0.79) and abduction (κ = 0.71) was good. Limitations Further testing is needed using a prospective design with a longer follow-up to determine whether self-managed prospective surveillance and timely treatment can hinder the development of chronic breast cancer–related upper body issues Conclusions Self-measured arm circumference and shoulder range of motion are reliable, and their inclusion in a hospital-based program of prospective surveillance for upper body issues seems feasible. This approach may improve early detection and treatment


2018 ◽  
Vol 11 (3) ◽  
pp. 204-209 ◽  
Author(s):  
Paul J Cagle ◽  
Birgit Werner ◽  
Dave R Shukla ◽  
Daniel A London ◽  
Bradford O Parsons ◽  
...  

Background Glenoid morphology, glenoid version and humeral head subluxation represent important parameters for the treating physician. The most common method of assessing glenoid morphology is the Walch classification which has only been validated with computed tomography (CT). Methods CT images and magnetic resonance imaging (MRI) images of 25 patients were de-identified and randomized. Three reviewers assessed the images for each parameter twice. The Walch classification was assessed with a weighted kappa value. Glenoid version and humeral head subluxation were comparted with a reproducibility coefficient. Results The Walch classification demonstrated almost perfect intraobserver agreement for MRI and CT images (k = 0.87). Weighted interobserver agreement values for the Walch classification were fair for CT and MRI (k = 0.34). The weighted reproducibility coefficient for glenoid version measured 9.13 (CI 7.16–12.60) degrees for CT and 13.44 (CI 10.54–18.55) degrees for MRI images. The weighted reproducibility coefficient for percentage of humeral head subluxation was 17.43% (CI 13.67–24.06) for CT and 18.49% (CI 14.5–25.52) for MRI images. Discussion CT and MRI images demonstrated similar efficacy in classifying glenoid morphology, measuring glenoid version and measuring posterior humeral head subluxation. MRI can be used as an alternative to CT for measuring these parameters.


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