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

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.

2018 ◽  
Vol 30 (4) ◽  
pp. 466-473 ◽  
Author(s):  
Ana Torres-Costoso ◽  
Dimitris Vlachopoulos ◽  
Esther Ubago-Guisado ◽  
Asunción Ferri-Morales ◽  
Iván Cavero-Redondo ◽  
...  

Purpose: The present study aims to investigate the association between dual-energy X-ray absorptiometry (DXA) and quantitative ultrasound (QUS) parameters and the intermethods agreement in active males. Methods: In this cross-sectional study, bone health (by DXA and calcaneal QUS), physical activity (by accelerometers), and anthropometrics measurements were assessed in 117 active adolescents (12–14 y old). Bivariate correlation coefficients were calculated to assess the relationships between DXA standard regions of interest and QUS parameters. Intraclass correlation coefficients and Bland–Altman plots were used to assess the level of agreement between bone mineral content regions derived from DXA and stiffness index. The measurements were z score transformed for comparison. Results: Most QUS parameters were positive and significantly correlated with DXA outcomes (stiffness index: r = .43–.52; broadband ultrasound attenuation: r = .50–.58; speed of sound: r = .25–.27) with the hip showing the highest correlations. Moreover, the present study found fair to good intraclass correlation coefficients of agreement (.60–.68) between DXA and QUS to assess bone health. The Bland–Altman analysis showed a limited percentage of outliers (3.2%–8.6%). Conclusion: QUS device could represent an acceptable alternative method to assess bone health in active adolescent males.


Blood ◽  
1981 ◽  
Vol 57 (2) ◽  
pp. 209-217 ◽  
Author(s):  
L Lenzerini ◽  
U Benatti ◽  
A Morelli ◽  
S Pontremoli ◽  
A De Flora ◽  
...  

Abstract FX is a red cell NADP(H)-binding protein that has been well defined biochemically and immunologically but whose function is still unknown. Preliminary data indicated that the levels of this protein are significantly increased in hemizygotes, heterozygotes, and homozygotes for the G6PD Mediterranean mutant, thus raising the question of whether or not the individual variation in FX levels is more or less directly influenced by X-linked genes. The present study, based on a large series of population and family data collected in Sardinia, confirms unequivocally the above mentioned interaction, but shows at the same time that the variances in FX levels “between sibships” are 2–3 times larger than those “within sibships,” when the analysis is done separately for the G6PD-normal or the G6PD-deficient sibs. From the comparison of the interclass and intraclass correlation coefficients, it appears that about 60% of the total variation of FX is of genetic origin. Moreover, the FX levels of children, analyzed in a pairwise manner, were found to be more positively correlated with those of their fathers (r = 0.39) than with those of their maternal grandfathers (0.20). This latter finding obviously favors the conclusion that “autosomal”; rather than “X-linked” genes are involved in the determination of the FX levels.


1989 ◽  
Vol 9 (5) ◽  
pp. 259-272 ◽  
Author(s):  
Jane Case-Smith

The Posture and Fine Motor Assessment of Infants (PFMAI) (Case-Smith, 1987) is a newly developed instrument for assessing the quality of motor function in infants. The test measures components of posture and fine motor control as they first develop. The purpose of this study was to support the test's reliability and validity. Interrater reliability, analyzed with intraclass correlation coefficients (ICCs), was high (.989 for total scores). Test-retest reliability, measured by ICCs, was .853 and .913 for the two test sections. The PFMAI demonstrated concurrent validity with the Peabody Developmental Motor Scales, Revised (Folio & Fewell, 1983) (correlations were .673 and .829 for the individual sections). Scores on the PFMAI were highly correlated with the infant's ages (.892 to .941); this finding provided one indication of construct validity.


2007 ◽  
Vol 122 (2) ◽  
pp. 177-180 ◽  
Author(s):  
Martin W Pak ◽  
Samuel Chow ◽  
C A van Hasselt

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.


2006 ◽  
Vol 3 (s1) ◽  
pp. S158-S175 ◽  
Author(s):  
Philip J. Troped ◽  
Ellen K. Cromley ◽  
Maren S. Fragala ◽  
Steven J. Melly ◽  
Hope H. Hasbrouck ◽  
...  

Background:To determine how trail characteristics may influence use, reliable and valid audit tools are needed.Methods:The Path Environment Audit Tool (PEAT) was developed with design, amenity, and aesthetics/maintenance items. Two observers independently audited 185 trail segments at 6 Massachusetts facilities. GPS-derived items were used as a “gold standard.” Kappa (k) statistics, observed agreement and intraclass correlation coefficients (ICCs) were calculated to assess inter-observer reliability and validity.Results:Fifteen of 16 primary amenity items had k-values ≥ 0.49 (“moderate”) and all had observed agreement ≥ 81%. Seven binary design items had k-values ranging from 0.19 to 0.71 and three of 5 ordinal items had ICCs ≥ 0.52. Only two aesthetics/maintenance items (n = 7) had moderate ICCs. Observed agreement between PEAT and GPS items was ≥ 0.77; k-values were ≥ 0.57 for 7 out of 10 comparisons.Conclusions:PEAT has acceptable reliability for most of its primary items and appears ready for use by researchers and practitioners.


2008 ◽  
Vol 33 (3) ◽  
pp. 369-372 ◽  
Author(s):  
K. THOMASON ◽  
K. L. SMITH

Sixteen observers measured eight anatomical parameters on digitalised images of six acute distal radial fractures using the Patient Archiving Communication System software and repeated the measurements at least 2 weeks later. Inter- and intraobserver reliability was calculated using intraclass correlation coefficients and tolerance limits. The highest interobserver agreement was demonstrated in the dorsal tilt (intraclass correlation coefficient 0.858; tolerance limit 14.2°). When compared with the results of a study looking at observer reliability in measurement of healed distal radial fractures, the reliability of computerised measurements is not significantly different from those achieved by manual techniques (dorsal tilt interobserver tolerance limits on computer system 16°, compared to 15° using ruler and protractor). These results suggest that the recommended radiological reduction limits for distal radius fractures of <10° change in palmar tilt, <2 mm radial shortening, <5° change in radial angle and a <1 to 2 mm articular step cannot be reliably measured.


2019 ◽  
Vol 2 (3) ◽  
pp. 37
Author(s):  
Claus Sixtus Jensen

Background: Paediatric early warning score (PEWS) assessment tools can assist healthcare providers in the timely detection and recognition of subtle patient condition changes signalling clinical deterioration. However, PEWS tools instrument data are only as reliable and accurate as the caregivers who obtain and document the parameters. The aim of this study is to evaluate inter-rater reliability among nurses using PEWS systems.  Method: The study was carried out in five paediatrics departments in the Central Denmark Region. Inter-rater reliability was investigated through parallel observations. A total of 108 children and 69 nurses participated. Two nurses simultaneously performed a PEWS assessment on the same patient. Before the assessment, the two participating nurses drew lots to decide who would be the active observer. Intraclass correlation coefficient, Fleiss’ κand Bland–Altman limits of agreement were used to determine inter-rater reliability. Results: The intraclass correlation coefficients for the aggregated PEWS score of the two PEWS models were 0.98 and 0.95, respectively. The κvalue on the individual PEWS measurements ranged from 0.70 to 1.0, indicating good to very good agreement. The nurses assigned the exact same aggregated score for both PEWS models in 76% of the cases. In 98% of the PEWS assessments, the aggregated PEWS scores assigned by the nurses were equal to or below 1 point in both models. Conclusion: The study showed good to very good interrater reliability in the two PEWS models used in the Central Denmark Region.


PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e7575
Author(s):  
Marisja Scheerhagen ◽  
Henk F. van Stel ◽  
Arie Franx ◽  
Erwin Birnie ◽  
Gouke J. Bonsel

Background The aim of the ReproQuestionnaire (ReproQ) is to measure the client’s experience with maternity care, following WHO’s responsiveness model. To support quality improvement, ReproQ should be able to discriminate best from worst organisational units. Methods We sent questionnaires to 27,487 third-trimester pregnant women (response 31%) and to 37,230 women 6 weeks after childbirth (response 39%). For analysis we first summarized the ReproQ domain scores into three summary scores: total score (all eight domains), personal score (four personal domains), and setting score (four setting domains). Second, we estimated the proportion of variance across perinatal units attributable to the ‘actual’ difference across perinatal units using intraclass correlation coefficients (ICCs). Third, we assessed the ability of ReproQ to discriminate between perinatal units based on both a statistical approach using multilevel regression analyses, and a relevance approach based on the minimally important difference (MID). Finally, we compared the domain scores of the best and underperforming units. Results ICCs ranged between 0.004 and 0.025 for the summary scores, and between 0.002 and 0.125 for the individual domains. ReproQ was able to identify the best and worst performing units with both the statistical and relevance approach. The statistical approach was able to identify four underperforming units during childbirth (total score), while the relevance approach identified 10 underperforming units. Conclusions ReproQ, a valid and efficient measure of client experiences in maternity care, has the ability to discriminate well across perinatal units, and is suitable for benchmarking under routine conditions.


2020 ◽  
Vol 163 (4) ◽  
pp. 822-828
Author(s):  
Anisha R. Noble ◽  
Erin Christianson ◽  
Susan J. Norton ◽  
Henry C. Ou ◽  
Grace S. Phillips ◽  
...  

Objectives Cochlear implant depth of insertion affects audiologic outcomes and can be measured in adults using plain films obtained in the “cochlear view.” The objective of this study was to assess interrater and intrarater reliability of measuring depth of insertion using cochlear view radiography. Study Design Prospective, observational. Setting Tertiary referral pediatric hospital. Subjects and Methods Patients aged 11 months to 20 years (median, 4 years; interquartile range [IQR], 1-8 years) undergoing cochlear implantation at our institution were studied over 1 year. Children underwent cochlear view imaging on postoperative day 1. Films were deidentified and 1 image per ear was selected. Two cochlear implant surgeons and 2 radiologists evaluated each image and determined angular depth of insertion. Images were re-reviewed 6 weeks later by all raters. Inter- and intrarater reliability were calculated with intraclass correlation coefficients (ICCs). Results Fifty-seven ears were imaged from 42 children. Forty-nine ears (86%) had successful cochlear view x-rays. Median angular depth of insertion was 381° (minimum, 272°; maximum, 450°; IQR, 360°-395°) during the first round of measurement. Measurements of the same images reviewed 6 weeks later showed median depth of insertion of 382° (minimum, 272°; maximum, 449°; IQR, 360°-397°). Interrater and intrarater reliability ICCs ranged between 0.81 and 0.96, indicating excellent reliability. Conclusions Postoperative cochlear view radiography is a reliable tool for measurement of cochlear implant depth of insertion in infants and children. Further studies are needed to determine reliability of intraoperatively obtained cochlear view radiographs in this population.


2021 ◽  
Vol 6 (11) ◽  
pp. 1020-1039
Author(s):  
Joshua B.V. Smith ◽  
Habeeb Bishi ◽  
Chao Wang ◽  
Vipin Asopa ◽  
Richard E. Field ◽  
...  

The purpose of this study was to compare the accuracy and the inter- and intra-observer reliability of preoperative digital 2D templating in prosthesis size prediction for the planning of cemented or uncemented THA. This study was registered in the NIHR PROSPERO database (ID: CRD420BLINDED) and conducted according to the PRISMA guidelines. A search of electronic databases in March 2021 found 29 papers overall. The quality of evidence was assessed using the IHE Quality Appraisal of Case Series Studies Checklist and the CASP Randomised Controlled Trials Checklist. A meta-analysis was conducted, and the accuracy was presented as proportions and the inter- and intra-observer reliability were measured using intraclass correlation coefficients (ICC). Accuracy within one prosthesis size (±1) for cemented stems was 0.89 (95% confidence interval (CI) 0.83–0.95), cemented cups 0.78 (95% CI 0.67–0.89), uncemented stems 0.74 (95% CI 0.66–0.82) and uncemented cups 0.73 (95% CI 0.67–0.79) (test of group differences: p = 0.010). Inter-observer reliability (ICC) for uncemented cups was 0.88 (95% CI 0.85–0.91), uncemented stems 0.86 (95% CI 0.81–0.91), cemented stems 0.69 (95% CI 0.54–0.84) and cemented cups 0.68 (95% CI 0.55–0.81) (test of group differences: p = 0.004). Due to lack of data, intra-observer reliability (ICC) could only be calculated for uncemented prostheses, which for the stems was 0.90 (95% CI 0.88–0.92) and for the cups was 0.87 (95% CI 0.83–0.90) (test of group differences: p = 0.124). The accuracy of preoperative digital templating is greater for cemented prostheses, but the inter-observer reliability is greater for uncemented prostheses. The intra-observer reliability showed a high level of agreement for uncemented prostheses. Cite this article: EFORT Open Rev 2021;6:1020-1039. DOI: 10.1302/2058-5241.6.210048


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