scholarly journals The Inter- and Intra-observer Reliability of Three Methods for Evaluating Carpal Collapse

2021 ◽  
Vol 8 (2) ◽  
pp. 71-76
Author(s):  
Hooman Shariatzade ◽  
◽  
Alireza Saied ◽  
Mohsen Barkam ◽  
Peyman Hashemi ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Intraclass Correlation ◽  
Height Ratio ◽  
Radiology Resident ◽  
Carpal Collapse ◽  
K Value ◽  
Hand Surgeon ◽  
Observer Reliability ◽  
Consecutive Time ◽  
Carpal Height

Background: Kienbock’s disease is a rare and debilitating condition. The decision for surgical intervention majorly depends on the extent of the carpal collapse. Therefore, the accurate measurement of carpal collapse is of critical importance. Objectives: The current study assessed the inter and intra-observer reliability of the three most frequent methods in measuring carpal height and determining carpal collapse. Methods: Fifty-Nine photocopied radiograms were reviewed by three observers (one senior orthopedic resident, one fellowship-trained hand surgeon, and one senior radiology resident) at 3 consecutive time points. Besides, one-week intervals were considered between the evaluations. The evaluated measures included the Carpal Height Ratio (CHR), Revised Carpal Height Ratio (RCHR), and Capitate-Radius (CR) index. The reliability of the measurements in determining the carpal height was examined using the Intraclass Correlation Coefficient (ICC). The agreement of the measures on determining the presence or absence of the carpal collapse was assessed by Cohen’s Kappa (K) value. Results: The overall inter and intra-observer reliability of the CR index in quantifying the carpal collapse was measured as 0.863 and 0.942, respectively. The overall inter and intra-observer reliability of CHR in quantifying the carpal collapse was computed to be 0.615 and 0.891, respectively. The overall inter and intra-observer reliability of RCHR in quantifying the carpal collapse equaled 0.412 and 0.792, respectively. The overall K for determining the presence or absence of a carpal collapse was calculated as 0.776, 0.683, and 0.549 for CR index, CHR, and RCHR, respectively. Conclusion: The CR index is the most reliable approach to measure carpal height. Furthermore, it is appropriate for determining the presence or absence of carpal collapse.

scholarly journals Radiographic and Computed Tomography Correlation of Kienböck's Disease: Is There a Need to Revisit Staging with Improved Imaging?

2019 ◽  
Vol 09 (01) ◽  
pp. 039-043
Author(s):  
Arvind Mohan ◽  
Richard Knight ◽  
Hiba Ismail ◽  
Ian A. Trail
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Ulnar Variance ◽  
Height Ratio ◽  
Carpal Collapse ◽  
Kienböck’S Disease ◽  
X Ray ◽  
Kienböck's Disease ◽  
Carpal Height ◽  
Kienbock’S Disease

AbstractCarpal height ratio and ulnar variance on plain X-ray were measured and compared to the width/height ratio of the lunate as measured on a computed tomography (CT) scan in 50 patients with Kienböck's disease. Width/height ratio of the lunate was also measured in a series of 50 controls. No correlation between ulnar variance and fractures was found. Conversely, the correlation between carpal height ratio on X-ray and width/height ratio on a CT scan was statistically significant. Similarly, the correlation between ulnar variance and width/height ratio was statistically significant. We have concluded that width/height ratio while correlating with carpal height is a better measure of lunate collapse. It also appeared that lunate collapse precedes carpal collapse, specifically most if not all lunates have collapsed prior to reduction in carpal height ratio. Finally, while we are unable to conclude the level at which the width/height ratio of lunate becomes unreconstructable, it does appear that in all Litchman stage 3b and most if not all of 3a the shape of the lunate has altered significantly.

KATZ AND STIRRAT HAND DIAGRAM REVISITED

Hand Surgery ◽  
2010 ◽  
Vol 15 (02) ◽  
pp. 71-73 ◽  
Author(s):  
Rouin Amirfeyz ◽  
Sanchit Mehendale ◽  
Sarah Tyrrell ◽  
Raj Bhatia ◽  
Ian Leslie ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Correlation Coefficient ◽  
Carpal Tunnel ◽  
Observer Agreement ◽  
Healthy Individuals ◽  
Intra Class Correlation ◽  
Hand Surgeon ◽  
Observer Reliability ◽  
Tunnel Syndrome ◽  
Intra Class Correlation Coefficient

Katz and Stirrat devised a hand diagram, which uses subjective information from the patient for the diagnosis of carpal tunnel syndrome (CTS). They reported a good result. We tested the inter-observer and intra-observer reliability of this hand diagram. Twenty five consecutive patients with a diagnosis of CTS, 25 with other common hand and wrist problems but CTS and 25 healthy individuals were prospectively recruited. Each patient filled in a hand diagram. Two experienced hand surgeon scored the diagrams blindly on two different sittings four-week apart. The intra-class correlation coefficient (ICC) and Cohen's Kappa were used for intra and inter-observer reliability respectively. The intra-observer agreement was poor (ICC 95% 0.33–0.65) and inter-observer was fair (Kappa = 0.241). This study does not support the use of Katz and Stirrat Hand Diagram for the diagnosis of carpal tunnel syndrome in place if a thorough clinical examination.

Evaluating the Validity and Reliability of the Persian Version of American Orthopedic Foot and Ankle Society Midfoot Scale

2022 ◽  
pp. 193864002110682
Author(s):  
Amir Reza Vosoughi ◽  
Amin Kordi Yoosefinejad ◽  
Yasaman Safaei Dehbarez ◽  
Zeinab Kargarshouraki ◽  
Hamideh Mahdaviazad
Keyword(s):  
Scoring System ◽  
Discriminant Validity ◽  
Intraclass Correlation ◽  
Foot And Ankle ◽  
Validity And Reliability ◽  
Persian Version ◽  
Observer Reliability ◽  
Persian Language ◽  
Sf 36 ◽  
American Orthopaedic

Background The use of a valid and reliable outcome scoring system is crucial for evaluating the result of different treatment interventions. The aims of this study were to translate and culturally adapt the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot scoring system into the Persian language and assess its validity and reliability. Method In total, 57 patients with midfoot injuries were enrolled. Forward-backward translation and cultural adaptation methods were used to develop the Persian version of AOFAS midfoot scoring system. Reliability and internal consistency were assessed using intraclass correlation coefficient (ICC) and Cronbach’s alpha. The discriminant and convergent validities of the scoring system were assessed using the total score of the mental and physical component of SF-36. Results The mean age of the participants was 46.2 ± 16.3 years. The intra-observer reliability of the totals core of the Persian version of AOFAS midfoot scoring system was 0.96 (confidence interval [CI]: 0.92-0.97) and the inter-observer reliability of the scoring system was 0.90 (CI: 0.86-0.95). The Persian version of AOFAS midfoot scoring system had acceptable convergence with physical component scoring system of SF-36 and its subscales (0.57); moreover, it had acceptable discriminant validity with the mental component of SF-36 and its subscales (0.36). Conclusion The Persian version of AOFAS midfoot is a reliable and valid instrument and could be used by Persian language clinicians and researchers. Level of Clinical Evidence: 3

scholarly journals Reliability of pre-operative diffusion tensor imaging parameter measurements of the cervical spine in patients with cervical spondylotic myelopathy

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Eugene Lee ◽  
Joon Woo Lee ◽  
Yun Jung Bae ◽  
Hyo Jin Kim ◽  
Yusuhn Kang ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Diffusion Tensor Imaging ◽  
Cervical Spondylotic Myelopathy ◽  
Diffusion Tensor ◽  
Intraclass Correlation ◽  
Measurement Methods ◽  
Retest Reliability ◽  
Observer Reliability ◽  
Spinal Cord Level ◽  
Test Retest Reliability

Abstract The present study assessed test–retest and inter-observer reliability of diffusion tensor imaging (DTI) in cervical spondylotic myelopathy (CSM), as well as the agreement among measurement methods. A total 34 patients (12 men, 22 women; mean age, 58.7 [range 45–79] years) who underwent surgical decompression for CSM, with pre-operative DTI scans available, were retrospectively enrolled. Four observers independently measured fractional anisotropy (FA) values twice, using three different measurement methods. Test–retest and inter-observer reliability was assessed using intraclass correlation coefficients (ICCs). Overall, inter-observer agreements varied according to spinal cord level and the measurement methods used, and ranged from poor to excellent agreement (ICC = 0.374–0.821), with relatively less agreement for the sagittal region of interest (ROI) method. The radiology resident and neuro-radiologist group showed excellent test–retest reliability at almost every spinal cord level (ICC = 0.887–0.997), but inter-observer agreements varied from fair to good (ICC = 0.404–0.747). Despite excellent test–retest reliability of the ROI measurements, FA measurements in patients with CSM varied widely in terms of inter-observer reliability. Therefore, DTI parameter data should be interpreted carefully when applied clinically.

scholarly journals Comparison of SDSG and CARDS classifications for L5/S1 lumbar degenerative spondylolisthesis: An independent inter- and intra-observer agreement study

2020 ◽  
Author(s):  
Chongqing Xu ◽  
Mengchen Yin ◽  
Wen Mo
Keyword(s):  
Treatment Plan ◽  
Degenerative Spondylolisthesis ◽  
Observer Agreement ◽  
Common Disease ◽  
Low Back ◽  
K Value ◽  
Observer Reliability ◽  
Lumbar Degenerative Spondylolisthesis ◽  
Radicular Symptoms ◽  
Agreement Study

Abstract Background Lumbar degenerative spondylolisthesis (DS) has been a common disease that make increasing patients suffer from different degrees of low back pain and radicular symptoms. SDSG and CARDS systems are commonly used to classify the disease, and help to make a more detailed treatment plan. The objective of this study is to evaluate the reliability and reproducibility of SDSG and CARDS classifications, and to explore their clinical application value. Methods/Design: All 117 patients with L5/S1 lumbar DS were enrolled. 5 spine surgeons who have certain clinical experience were selected. They determined the classification according to S SDSG and CARDS systems, we used kappa (K) value to check the coefficient consistency for multi-factor and assess the inter- and intra-observer agreement. After 12 weeks, we repeated the analysis. Results The inter-observer reliability and intra-observer reproducibility of SDSG system were substantial with K values of 0.704 and 0.861, while those of CARDS system were substantial with values of 0.620 and 0.878. Conclusion SDSG system has better inter-observer reliability in comparison with CARDS system, and though CARDS system is more intuitive and simpler, it is more likely to produce deviations when using it. Since both SDSG and CARDS systems show substantial agreement and have great significance in surgical strategy of L5/S1 lumbar DS, they can be widely used in clinical practice.

scholarly journals Computer-based three-dimensional measurement of carpal alignment: measurement techniques and normal ranges

2021 ◽  
pp. 175319342110396
Author(s):  
Robert M. J. Sippo ◽  
Theresa E. K. Höglund ◽  
Eero Waris
Keyword(s):  
Measurement Techniques ◽  
Intraclass Correlation ◽  
Three Dimensional ◽  
Reference Database ◽  
Mean Values ◽  
Observer Reliability ◽  
Normal Ranges ◽  
Asymptomatic Volunteers ◽  
Ct Analysis ◽  
Computer Based

The three-dimensional carpal alignment was measured in the neutral wrist position in 121 asymptomatic volunteers using computer-based cone-beam CT analysis. Normal values and the reliability of the automated analysis are reported. An analysis software based on segmentation of CT images and mathematical modelling was used to determine several axis variants based on different landmarks and to calculate the intercarpal angles automatically. Twenty wrists were imaged twice to determine intra-observer reliability. Mean values using the preferred axis variants were: scapholunate angle 57° (SD 9°), radiolunate angle 2° (SD 10°), lunocapitate angle –14° (SD 9°). Using alternate axis variants notably changed the angles produced. The intra-observer reliability of the analysis was excellent (mean intraclass correlation coefficient 0.97, SD 0.03). Computer-based CT analysis enables highly reproducible and automated assessment of carpal alignment. This study provides a reference database for measurement techniques and normal carpal angle values in three-dimensional imaging.

scholarly journals The reliability of the augmented Lehnert-Schroth and Rigo classification in scoliosis management

2021 ◽  
Vol 77 (2) ◽  
Author(s):  
Burçin Akçay ◽  
Tuğba Kuru Çolak ◽  
Adnan Apti ◽  
İlker Çolak ◽  
Önder Kızıltaş
Keyword(s):  
Treatment Plan ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Error Measurement ◽  
X Rays ◽  
X Ray ◽  
Intraclass Correlation Coefficients ◽  
Observer Reliability ◽  
The Individual ◽  
Curve Patterns

Background: In pattern-specific scoliosis exercises and bracing, the corrective treatment plan differs according to different curve patterns. There are a limited number of studies investigating the reliability of the commonly used classifications systems.Objective: To test the reliability of the augmented Lehnert-Schroth (ALS) classification and the Rigo classification.Methods: X-rays and posterior photographs of 45 patients with scoliosis were sent by the first author to three clinicians twice at 1-week intervals. The clinicians classified images according to the ALS and Rigo classifications, and the data were analysed using SPSS V-16. Intraclass correlation coefficients (ICCs) and standard error measurement (SEM) were calculated to evaluate the inter- and intra-observer reliability.Results: The inter-observer ICC values were 0.552 (ALS), 0.452 (Rigo) for X-ray images and 0.494 (ALS), 0.518 (Rigo) for the photographs. The average intra-observer ICC value was 0.720 (ALS), 0.581 (Rigo) for the X-ray images and 0.726 (ALS) and 0.467 (Rigo) for the photographs.Conclusions: The results of our study indicate moderate inter-observer reliability for X-ray images using the ALS classification and clinical photographs using the Rigo classification. Intra-observer reliability was moderate to good for X-ray images and clinical photographs using the ALS classification and poor to moderate for X-ray and clinical photographs using the Rigo classification.Clinical implications: Pattern classifications assist in creating a plan and indication of correction in specific scoliosis physiotherapy and pattern-specific brace applications and surgical treatment. More sub-types are needed to address the individual patterns of curvature. The optimisation of curve classification will likely reduce failures in diagnosis and treatment.

Effect of Trapeziectomy on Carpal Stability

Hand ◽  
2020 ◽  
pp. 155894472093919
Author(s):  
Aaron W. Paul ◽  
Christian M. Athens ◽  
Raahil Patel ◽  
Marco Rizzo ◽  
Peter C. Rhee
Keyword(s):  
Outcome Measures ◽  
Degenerative Change ◽  
Classification Systems ◽  
Radiographic Outcome ◽  
Carpal Collapse ◽  
The Mean ◽  
Dorsal Intercalated Segment Instability ◽  
Tendon Interposition ◽  
Carpal Height

Background: The scaphoid-trapezoid-trapezium (STT) articulation stabilizes the scaphoid and links the proximal and distal carpal rows. The purpose of the study was to determine whether trapezium excision in the treatment of trapeziometacarpal (TM) arthritis affects carpal stability. Methods: A retrospective chart and radiographic review was performed on all wrists that underwent trapeziectomy with suspensionplasty or ligament reconstruction, and tendon interposition for TM arthritis between 2004 and 2016. Radiographic outcome measures included the modified carpal height ratio (MCHR) and radioscaphoid (RS), radiolunate (RL), and scapholunate (SL) angles. Degenerative change at the TM and STT joints was classified according to the Eaton-Littler, and Knirk and Jupiter classification systems. Radiographic parameters were compared between preoperative and final follow-up time points. Results: A total of 122 wrists were included in the study with a mean follow-up of 3.5 years (range: 1.0-13.0 years). The mean RL (range: −2.2° ± 11.8° to −10.7° ± 16.5°) and RS angles (range: 52.6° ± 13.8° to 44.4° ± 17.8°) decreased significantly (<.001) without significant change in SL angle, indicating progressive lunate and scaphoid extension after trapeziectomy. The mean MCHR decreased significantly (range: 1.6 ± 0.1 to 1.5 ± 0.1) following trapeziectomy, indicating progressive carpal collapse. Progressive scaphoid-trapezoid arthrosis was observed following trapeziectomy. No other preoperative radiographic factors investigated were associated with significant differences in preoperative and postoperative values for radiographic outcome measures. Conclusions: Trapeziectomy can lead to loss of carpal height, coordinated extension of both the lunate and scaphoid, and progressive scaphotrapezoid arthrosis. As such, in wrists with dynamic or static carpal instability, trapeziectomy should be performed with caution due to the risk of carpal collapse with a nondissociative pattern of dorsal intercalated segment instability.

KIENBÖCK DISEASE TREATED BY EXCISIONAL ARTHROPLASTY WITH A PALMARIS LONGUS TENDON BALL: A COMPARATIVE STUDY OF CASES WITH OR WITHOUT BONE CORE

Hand Surgery ◽  
2004 ◽  
Vol 09 (02) ◽  
pp. 145-149 ◽  
Author(s):  
A. Sakai ◽  
N. Toba ◽  
T. Oshige ◽  
K. Menuki ◽  
H. Hirasawa ◽  
...  
Keyword(s):  
Comparative Study ◽  
Stage Iiia ◽  
Height Ratio ◽  
Longus Tendon ◽  
Palmaris Longus ◽  
Kienböck Disease ◽  
Palmaris Longus Tendon ◽  
One Year ◽  
Carpal Height

We hypothesised that using a palmaris longus tendon ball (PLTB) with bone core (w bc) after excisional arthroplasty for Kienböck disease would maintain post-operative carpal height compared to a PLTB without bone core (w/o bc). Seventeen hands of 16 consecutive patients with Kienböck disease at Lichtman stage IIIA or IIIB were treated by replacement of the lunate with a PLTB w bc or w/o bc. We evaluated the clinical and radiological outcomes at one, three and 12 months after surgery. According to Dornan and Lichtman criteria respectively, there were no significant differences between the two groups. In the w bc group, the post-operative values of the carpal height ratio (CHR) were maintained at the same level as pre-operative values for one year, while the post-operative CHR values in the w/o bc group were significantly lower than those in the w bc group. Our results indicate that in Kienböck disease, arthroplasty using a PLTB w bc can maintain CHR at one year after surgery compared to arthroplasty using a PLTB w/o bc.

The choice of chromogen and reliability of contact rhinoscopy in the irradiated nasopharynx

2007 ◽  
Vol 122 (2) ◽  
pp. 177-180 ◽  
Author(s):  
Martin W Pak ◽  
Samuel Chow ◽  
C A van Hasselt
Keyword(s):  
Methylene Blue ◽  
Squamous Metaplasia ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Cross Sectional ◽  
Vital Stain ◽  
Intraclass Correlation Coefficients ◽  
Observer Reliability ◽  
Blue Stain ◽  
The Mean

AbstractA cross-sectional randomised single blind study was conducted to assess how concentrations of chromogen (vital stain) and the characteristics of the assessors affect the assessment of contact rhinoscopy. Twenty-eight patients who had undergone external radiotherapy for nasopharyngeal carcinoma were assessed by contact rhinoscopy using 0.5 per cent and 1 per cent methylene blue stain on opposite sides of the nasopharynx. Three independent observers assessed the visual clarity of the 45 contact endoscopic images showing squamous metaplasia according to a visual analogue scale. The intraclass correlation coefficients were 0.916 to 0.957 and 0.839 to 0.964 for intra-observer reliability of assessors in the groups of 0.5 per cent and 1 per cent stains, respectively. The intraclass correlation coefficients for inter-observer reliability of assessors were 0.884 and 0.885 in the groups of 0.5 per cent and 1 per cent stains, respectively. The mean scores of clarity of the cellular details were statistically higher in the group of 1 per cent stain among all assessors. These results showed that the assessment of squamous metaplasia by contact endoscopy is highly reliable irrespective of the clinical experience and knowledge of histopathology of the assessors. One per cent methylene blue should be the vital stain of choice in contact endoscopy.

Sign in / Sign up

Export Citation Format

Share Document