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Comparing dependent kappa coefficients obtained on multilevel data.

ABSTRACT: Reliability and agreement are two notions of paramount importance in medical and behavioral sciences. They provide information about the quality of the measurements. When the scale is categorical, reliability and agreement can be quantified through different kappa coefficients. The present paper provides two simple alternatives to more advanced modeling techniques, which are not always adequate in case of a very limited number of subjects, when comparing several dependent kappa coefficients obtained on multilevel data. This situation frequently arises in medical sciences, where multilevel data are common. Dependent kappa coefficients can result from the assessment of the same individuals at various occasions or when each member of a group is compared to an expert, for example. The method is based on simple matrix calculations and is available in the R package "multiagree". Moreover, the statistical properties of the proposed method are studied using simulations. Although this paper focuses on kappa coefficients, the method easily extends to other statistical measures.

SUBMITTER: Vanbelle S

PROVIDER: S-EPMC5600130 | biostudies-literature | 2017 Sep

REPOSITORIES: biostudies-literature

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Comparing dependent kappa coefficients obtained on multilevel data.

Vanbelle Sophie S

Biometrical journal. Biometrische Zeitschrift 20170502 5

Reliability and agreement are two notions of paramount importance in medical and behavioral sciences. They provide information about the quality of the measurements. When the scale is categorical, reliability and agreement can be quantified through different kappa coefficients. The present paper provides two simple alternatives to more advanced modeling techniques, which are not always adequate in case of a very limited number of subjects, when comparing several dependent kappa coefficients obta ...[more]

PMID: 28464322

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Project description:BackgroundDedicated cone-beam breast computed tomography (CBBCT) using short-scan acquisition is being actively investigated to potentially reduce the radiation dose to the breast. This would require determining the optimal x-ray source trajectory for such short-scan acquisition.PurposeTo quantify the projection angle-dependent normalized glandular dose coefficient ( DgNCT$Dg{N^{CT}}$ ) in CBBCT, referred to as angular DgNCT$Dg{N^{CT}}$ , so that the x-ray ray source trajectory that minimizes the radiation dose to the breast for short-scan acquisition can be determined.Materials and methodsA cohort of 75 CBBCT clinical datasets was segmented and used to generate three breast models - (I) patient-specific breast with heterogeneous fibroglandular tissue distribution and real breast shape, (II) patient-specific breast shape with homogeneous tissue distribution and matched fibroglandular weight fraction, and (III) homogeneous semi-ellipsoidal breast with patient-specific breast dimensions and matched fibroglandular weight fraction, which corresponds to the breast model used in current radiation dosimetry protocols. For each clinical dataset, the angular DgNCT$Dg{N^{CT}}$ was obtained at 10 discrete angles, spaced 36° apart, for full-scan, circular, x-ray source trajectory from Monte Carlo simulations. Model III is used for validating the Monte Carlo simulation results. Models II and III are used to determine if breast shape contributes to the observed trends in angular DgNCT$Dg{N^{CT}}$ . A geometry-based theory in conjunction with center-of-mass ( COM$COM$ ) based distribution analysis is used to explain the projection angle-dependent variation in angular DgNCT$Dg{N^{CT}}$ .ResultsThe theoretical model predicted that the angular DgNCT$Dg{N^{CT}}$ will follow a sinusoidal pattern and the amplitude of the sinusoid increases when the center-of-mass of fibroglandular tissue ( COMf$CO{M_f}$ ) is farther from the center-of-mass of the breast ( COMb$CO{M_b}$ ). It also predicted that the angular DgNCT$Dg{N^{CT}}$ will be minimized at x-ray source positions complementary to the COMf$CO{M_f}$ . The COMf$CO{M_f}$ was superior to the COMb$CO{M_b}$ in 80% (60/75) of the breasts. From Monte Carlo simulations and for homogeneous breasts (models II and III), the deviation in breast shape from a semi-ellipsoid had minimal effect on angular DgNCT$Dg{N^{CT}}$ and showed less than 4% variation. From Monte Carlo simulations and for model I, as predicted by our theory, the angular DgNCT$Dg{N^{CT}}$ followed a sinusoidal pattern with maxima and minima at x-ray source positions superior and inferior to the breast, respectively. For model I, the projection angle-dependent variation in angular DgNCT$Dg{N^{CT}}$ was 16.4%.ConclusionThe heterogeneous tissue distribution affected the angular DgNCT$Dg{N^{CT}}$ more than the breast shape. For model I, the angular DgNCT$Dg{N^{CT}}$ was lowest when the x-ray source was inferior to the breast. Hence, for short-scan CBBCT acquisition with COMb$CO{M_b}$ aligned with axis-of-rotation, an x-ray source trajectory inferior to the breast is preferable and such an acquisition spanning 205° can potentially reduce the mean glandular dose by up to 52%.

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Comparing dependent kappa coefficients obtained on multilevel data.

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Comparing dependent kappa coefficients obtained on multilevel data.

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