Independent Analysis of the Dorr Classification of Proximal Femoral Morphology: A Reliability Study

ABSTRACT The purpose of this study was to assess the inter- and intraobserver reliability through visual perception of a previously described classification system of proximal femoral morphology. The interobserver reliability ranged from slight to moderate across testing. Experience appears to play a role as the intratester reliability did not differ with fellowship trained attending physicians, but differences were seen with junior- and senior-level residents. The diversity of the proximal femoral morphology likely represents a continuum rather than three distinct shapes. This may imply that for many proximal femoral canals, characterization of a single type may not be possible. Further research is warranted to determine the clinical significance of these findings. Jennings JM, Thiele RAR, Krynetskiy E, Wellman SS, Attarian DE, Bolognesi MP. Independent Analysis of the Dorr Classification of Proximal Femoral Morphology: A Reliability Study. The Duke Orthop J 2016;6(1):12-16.

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

10.21203/rs.3.rs-128390/v1 ◽

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.

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A Classification-System Improves the Intra- and Interobserver Reliability of Radiographic Diagnosis of “Pistol-Grip-Deformity”

Hip International ◽

10.5301/hip.2011.8821 ◽

2011 ◽

Vol 21 (6) ◽

pp. 732-739 ◽

Cited By ~ 3

Author(s):

Ingmar Ipach ◽

Eva-Maria Arlt ◽

Falk Mittag ◽

Beate Kunze ◽

Petra Wolf ◽

...

Keyword(s):

Lower Limit ◽

Classification System ◽

Interobserver Reliability ◽

Alpha Angle ◽

Treatment Algorithm ◽

Kappa Coefficient ◽

Intraobserver Agreement ◽

Single Plane ◽

Upper Limit

Early detection of pistol-grip-deformity may be beneficial in optimising the outcome and the cost effectiveness of surgery. It is important to identify reliable radiographic parameters in assessing femoro-acetabular impingement (FAI) to develop a treatment algorithm. Radiographs of 47 patients ranging from “pistol grip deformity” to a normal head-neck-junction were measured for alpha angle and head ratio, and then classified by two different observers. The Bland-Altman plot was used for inter- and intraobserver agreement of alpha angle and head ratio. Inter- and intraobserver agreement for classification of “pistol grip deformity” was determined using weighted Cohen's kappa coefficient. Observer I achieved a kappa coefficient of 0.97. Observer II achieved a kappa coefficient of 0.92. An interobserver kappa coefficient between 0.87 and 0.92 was achieved by using a classification system. By testing for interobserver agreement, a bias of –0.004 with an upper limit of 0.461 and a lower limit of –0.47 was seen for the ratio and a bias of –3.7 with an upper limit of 17.2 and a lower limit of –24.6 for the alpha angle. Therefore, poor results were seen for intra- and interobserver reliability by using only a single plane for classification of “pistol grip deformity”. The strength of agreement could be improved by using a classification system (based on two planes).

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RELIABILITY OF LICHTMAN'S CLASSIFICATION FOR KIENBÖCK'S DISEASE IN 99 SUBJECTS

Hand Surgery ◽

10.1142/s0218810411005035 ◽

2011 ◽

Vol 16 (01) ◽

pp. 15-18 ◽

Cited By ~ 3

Author(s):

Masaki Shin ◽

Masahiro Tatebe ◽

Hitoshi Hirata ◽

Shukuki Koh ◽

Takaaki Shinohara

Keyword(s):

Classification System ◽

Wrist Joint ◽

Interobserver Reliability ◽

Clinical Settings ◽

X Rays ◽

New Classification ◽

Kienböck’S Disease ◽

Kienböck's Disease ◽

Kienbock’S Disease

Purpose: The objective of this research was to investigate the reliability of Lichtman's classification for Kienböck's disease. Methods: Interobserver reliability and intraobserver reproducibility were investigated by interpreting both anteroposterior and lateral X-rays of the wrist joint twice in 99 patients with Kienböck's disease using the modified Lichtman's classification system. Observers comprised three orthopaedic surgeons, and no information was exchanged between observers either before or during the study. Results: Intraobserver reliability was moderate (0.313–0.628), and interobserver reliability was fair (Siegel's kappa = 0.228). Conclusion: Low values were obtained regarding interobserver reliability for the modified Lichtman's classification of Kienböck's disease. This classification is thus inadequate for use in clinical settings. A new classification should be established.

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Classification System of Pathological Voices Using Correntropy

Mathematical Problems in Engineering ◽

10.1155/2014/924786 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 18

Author(s):

Aluisio I. R. Fontes ◽

Pedro T. V. Souza ◽

Adrião D. D. Neto ◽

Allan de M. Martins ◽

Luiz F. Q. Silveira

Keyword(s):

Information Theory ◽

Success Rate ◽

Similarity Measure ◽

Classification System ◽

Computational Simulation ◽

Spectral Characteristics ◽

Automatic Classification

This paper proposes the use of a similarity measure based on information theory called correntropy for the automatic classification of pathological voices. By using correntropy, it is possible to obtain descriptors that aggregate distinct spectral characteristics for healthy and pathological voices. Experiments using computational simulation demonstrate that such descriptors are very efficient in the characterization of vocal dysfunctions, leading to a success rate of 97% in the classification. With this new architecture, the classification process of vocal pathologies becomes much more simple and efficient.

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Three-dimensional classification of the Lenke 1 adolescent idiopathic scoliosis using coronal and lateral spinal radiographs

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03798-x ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Saba Pasha ◽

Victor Ho-Fung ◽

Malcolm Eker ◽

Sarah Nossov ◽

Michael Francavilla

Keyword(s):

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Classification System ◽

Classification Accuracy ◽

Interobserver Reliability ◽

Three Dimensional ◽

Classification Systems ◽

Dimensional Classification ◽

Third Dimension

Abstract Background Classification of the spinal deformity in adolescent idiopathic scoliosis (AIS) remains two-dimensional (2D) as the spinal radiographs remain the mainstay in clinical evaluation of the disease. 3D classification systems are proposed, however are time consuming. We here aim to evaluate the clinical application of a 3D classification system by the use of only posterior-anterior and lateral radiographs in Lenke 1 adolescent idiopathic scoliosis (AIS). Methods Forty Lenke 1 AIS were classified by five observers following a three-step flowchart, developed based on our previous 3D classification system. This 3D classification characterizes the curve in the frontal and sagittal views and infers the third dimension with rules based on prior data to determine the 3D subtypes of the curve. Repeated rating was performed for 20 randomly selected patients in the same cohort. In addition to the classification by the raters, the 3D model of the spines were generated to determine the actual curve subtype based on the algorithm that was originally used to develop the 3D classification system. The interobserver and intraobserver reliability and the classification accuracy were determined for both 3D and axial classifications of the cohort. Results The interobserver reliability was moderate to strong with a kappa value between 0.61–0.89 for 3D and axial classifications. Comparing the mathematical classification and the raters’ classification, the classification accuracy among all raters ranged between 56 and 89%. Conclusion We evaluated the reliability of a previously developed 3D classification system for Lenke 1 AIS patients when only two-view spinal radiographs are available. Radiologists and orthopedic surgeons were able to identify the 3D subtypes of Lenke 1 AIS from the patients’ radiographs with moderate to strong reliability. The new 3D classification has the potential to identify the subtypes of the Lenke 1 AIS without a need for quantitative 3D image post-processing.

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

Der Orthopäde ◽

10.1007/pl00003655 ◽

1999 ◽

Vol 28 (8) ◽

pp. 662-681 ◽

Cited By ~ 3

Author(s):

M. Blauth ◽

◽

L. Bastian ◽

C. Knop ◽

U. Lange ◽

...

Keyword(s):

Interobserver Reliability

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Morphological and Ultrastructural Characterization of Hemocytes in an Insect Model, the Hematophagous Dipetalogaster maxima (Hemiptera: Reduviidae)

Insects ◽

10.3390/insects12070640 ◽

2021 ◽

Vol 12 (7) ◽

pp. 640

Author(s):

Natalia R. Moyetta ◽

Fabián O. Ramos ◽

Jimena Leyria ◽

Lilián E. Canavoso ◽

Leonardo L. Fruttero

Keyword(s):

Cell Biology ◽

Cell Types ◽

Transmission Electron ◽

Ultrastructural Characterization ◽

Current Classification ◽

Contrast Microscopy ◽

First Time ◽

Controversial Aspect

Hemocytes, the cells present in the hemolymph of insects and other invertebrates, perform several physiological functions, including innate immunity. The current classification of hemocyte types is based mostly on morphological features; however, divergences have emerged among specialists in triatomines, the insect vectors of Chagas’ disease (Hemiptera: Reduviidae). Here, we have combined technical approaches in order to characterize the hemocytes from fifth instar nymphs of the triatomine Dipetalogaster maxima. Moreover, in this work we describe, for the first time, the ultrastructural features of D. maxima hemocytes. Using phase contrast microscopy of fresh preparations, five hemocyte populations were identified and further characterized by immunofluorescence, flow cytometry and transmission electron microscopy. The plasmatocytes and the granulocytes were the most abundant cell types, although prohemocytes, adipohemocytes and oenocytes were also found. This work sheds light on a controversial aspect of triatomine cell biology and physiology setting the basis for future in-depth studies directed to address hemocyte classification using non-microscopy-based markers.

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Semi-automated regional classification of the style of activity of slow rock-slope deformations using PS InSAR and SqueeSAR velocity data

Landslides ◽

10.1007/s10346-021-01654-0 ◽

2021 ◽

Author(s):

Chiara Crippa ◽

Elena Valbuzzi ◽

Paolo Frattini ◽

Giovanni B. Crosta ◽

Margherita C. Spreafico ◽

...

Keyword(s):

Rock Slope ◽

Progressive Failure ◽

Principal Component ◽

Cost Effective ◽

Displacement Rate ◽

Machine Learning Classification ◽

Management Perspective ◽

Alpine Environments

AbstractLarge slow rock-slope deformations, including deep-seated gravitational slope deformations and large landslides, are widespread in alpine environments. They develop over thousands of years by progressive failure, resulting in slow movements that impact infrastructures and can eventually evolve into catastrophic rockslides. A robust characterization of their style of activity is thus required in a risk management perspective. We combine an original inventory of slow rock-slope deformations with different PS-InSAR and SqueeSAR datasets to develop a novel, semi-automated approach to characterize and classify 208 slow rock-slope deformations in Lombardia (Italian Central Alps) based on their displacement rate, kinematics, heterogeneity and morphometric expression. Through a peak analysis of displacement rate distributions, we characterize the segmentation of mapped landslides and highlight the occurrence of nested sectors with differential activity and displacement rates. Combining 2D decomposition of InSAR velocity vectors and machine learning classification, we develop an automatic approach to characterize the kinematics of each landslide. Then, we sequentially combine principal component and K-medoids cluster analyses to identify groups of slow rock-slope deformations with consistent styles of activity. Our methodology is readily applicable to different landslide datasets and provides an objective and cost-effective support to land planning and the prioritization of local-scale studies aimed at granting safety and infrastructure integrity.

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The Underlying Order Induced by Orthogonality and the Quantum Speed Limit

Quantum Reports ◽

10.3390/quantum3030024 ◽

2021 ◽

Vol 3 (3) ◽

pp. 376-388

Author(s):

Francisco J. Sevilla ◽

Andrea Valdés-Hernández ◽

Alan J. Barrios

Keyword(s):

Energy Spectrum ◽

Energy Distribution ◽

Finite Time ◽

Complete Characterization ◽

Comprehensive Analysis ◽

Orthogonality Condition ◽

Speed Limit ◽

Physical Quantities

We perform a comprehensive analysis of the set of parameters {ri} that provide the energy distribution of pure qutrits that evolve towards a distinguishable state at a finite time τ, when evolving under an arbitrary and time-independent Hamiltonian. The orthogonality condition is exactly solved, revealing a non-trivial interrelation between τ and the energy spectrum and allowing the classification of {ri} into families organized in a 2-simplex, δ2. Furthermore, the states determined by {ri} are likewise analyzed according to their quantum-speed limit. Namely, we construct a map that distinguishes those ris in δ2 correspondent to states whose orthogonality time is limited by the Mandelstam–Tamm bound from those restricted by the Margolus–Levitin one. Our results offer a complete characterization of the physical quantities that become relevant in both the preparation and study of the dynamics of three-level states evolving towards orthogonality.

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Molecular Classification and Tumor Microenvironment Characterization of Gallbladder Cancer by Comprehensive Genomic and Transcriptomic Analysis

Cancers ◽

10.3390/cancers13040733 ◽

2021 ◽

Vol 13 (4) ◽

pp. 733

Author(s):

Nobutaka Ebata ◽

Masashi Fujita ◽

Shota Sasagawa ◽

Kazuhiro Maejima ◽

Yuki Okawa ◽

...

Keyword(s):

Tumor Microenvironment ◽

Gallbladder Cancer ◽

Epithelial To Mesenchymal Transition ◽

Molecular Classification ◽

Mesenchymal Transition ◽

Elevated Expression ◽

Fresh Frozen ◽

Therapeutic Decision Making

Gallbladder cancer (GBC), a rare but lethal disease, is often diagnosed at advanced stages. So far, molecular characterization of GBC is insufficient, and a comprehensive molecular portrait is warranted to uncover new targets and classify GBC. We performed a transcriptome analysis of both coding and non-coding RNAs from 36 GBC fresh-frozen samples. The results were integrated with those of comprehensive mutation profiling based on whole-genome or exome sequencing. The clustering analysis of RNA-seq data facilitated the classification of GBCs into two subclasses, characterized by high or low expression levels of TME (tumor microenvironment) genes. A correlation was observed between gene expression and pathological immunostaining. TME-rich tumors showed significantly poor prognosis and higher recurrence rate than TME-poor tumors. TME-rich tumors showed overexpression of genes involved in epithelial-to-mesenchymal transition (EMT) and inflammation or immune suppression, which was validated by immunostaining. One non-coding RNA, miR125B1, exhibited elevated expression in stroma-rich tumors, and miR125B1 knockout in GBC cell lines decreased its invasion ability and altered the EMT pathway. Mutation profiles revealed TP53 (47%) as the most commonly mutated gene, followed by ELF3 (13%) and ARID1A (11%). Mutations of ARID1A, ERBB3, and the genes related to the TGF-β signaling pathway were enriched in TME-rich tumors. This comprehensive analysis demonstrated that TME, EMT, and TGF-β pathway alterations are the main drivers of GBC and provides a new classification of GBCs that may be useful for therapeutic decision-making.

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