Dataset Information

Interobserver and intraobserver variations in radial head fracture classification-assessment of two classification systems.

ABSTRACT: Objective:The aim of this study was to evaluate the intra- and interobserver variation of two classification systems for radial head fractures (Mason and Charalambous classifications) using plain radiographs. Material and methods:Five observers classified 30 radial head fractures as per the two classifications using anteroposterior and lateral elbow radiographs. Assessments were done on two occasions, at least 6 weeks apart. Results:The interobserver and intraobserver variation of the Mason classification showed fair (mean kappa?=?0.33) and moderate agreement (mean kappa?=?0.43) respectively. The interobserver and intraobserver variation of the Charalambous classification showed moderate agreement for both (mean kappa?=?0.42 and 0.49 respectively). A greater proportion of radial head fractures could be classified using the Charalambous classification compared with the Mason classification (P?

SUBMITTER: Ayyaswamy B

PROVIDER: S-EPMC6818393 | biostudies-literature | 2019 Nov-Dec

REPOSITORIES: biostudies-literature

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Interobserver and intraobserver variations in radial head fracture classification-assessment of two classification systems.

Ayyaswamy Brijesh B Howell Laura L Anand Anoop A Charalambous Charalambos P CP

Journal of orthopaedics 20190528 6

<h4>Objective</h4>The aim of this study was to evaluate the intra- and interobserver variation of two classification systems for radial head fractures (Mason and Charalambous classifications) using plain radiographs.<h4>Material and methods</h4>Five observers classified 30 radial head fractures as per the two classifications using anteroposterior and lateral elbow radiographs. Assessments were done on two occasions, at least 6 weeks apart.<h4>Results</h4>The interobserver and intraobserver varia ...[more]

PMID: 31680732

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Project description:BackgroundAvascular necrosis (AVN) of the femoral head is a concerning complication that can result from treatments for developmental dysplasia of the hip (DDH). AVN can lead to degenerative osteoarthritis, persistent acetabular dysplasia, reduced function, and continuing hip pain. The incidence of AVN reported in the DDH literature is widely varied (0% to 73%). This variability may arise from lack of consensus on what constitutes true AVN in this patient population, and lack of clear criteria provided in studies reporting incidence rates.MethodsA multicentre, prospective database of infants diagnosed with DDH between 2010 and 2014 from 0 to 18 months of age was analyzed for patients treated by closed reduction (CR). Twelve pediatric orthopaedic surgeons completed 2 rounds of AVN assessments. Deidentified anteroposterior radiographs at most recent follow-up were provided to surgeons along with patient age at radiographic assessment, length of follow-up, ands affected hip. Ten of 12 surgeons completed a third round of assessments where they were provided with 1 to 2 additional radiographs within the follow-up period. Radiographic criteria for total AVN described by Salter and colleagues were used. Surgeons rated the presence of AVN as "yes" or "no" and kappa values were calculated within and between rounds.ResultsA total of 69 hips in 60 patients were assessed for AVN a median of 22 months (range: 12 to 36) post-CR. Interobserver kappa values for rounds 1, 2, and 3 were 0.52 (range: 0.11 to 0.90), 0.61 (range: 0.21 to 0.90), and 0.53 (range: 0.10 to 0.79), respectively. Intraobserver agreement for AVN diagnosis was an average of 0.72 (range: 0.31 to 0.96).ConclusionsDespite using the most commonly referenced diagnostic criteria, radiographic diagnosis of AVN following CR in DDH patients demonstrated only moderate agreement across surgeons. The addition of sequential radiographs did not improve cross-observer reliability, and while substantial agreement was seen within observers, the range of intraobserver kappa values was large.Level of evidenceLevel I-diagnostic study.

Project description:BACKGROUND:The 13-lined ground squirrel (13-LGS) possesses a cone-dominant retina that is highly amenable to non-invasive high-resolution retinal imaging. The ability for longitudinal assessment of a cone-dominant photoreceptor mosaic with an adaptive optics scanning light ophthalmoscope (AOSLO) has positioned the 13-LGS to become an accessible model for vision research. Here, we examine the interocular symmetry, repeatability, and reliability of cone density measurements in the 13-LGS. METHODS:Thirteen 13-LGS (18 eyes) were imaged along the vertical meridian with a custom AOSLO. Regions of interest were selected superior and inferior to the optic nerve head, including the cone-rich visual streak. Non-confocal split-detection was used to capture images of the cone mosaic. Five masked observers each manually identified photoreceptors for 26 images three times and corrected an algorithm's cell identification outputs for all 214 images three times. Intraobserver repeatability and interobserver reliability of cone density were characterized using data collected from all five observers, while interocular symmetry was assessed in five animals using the average values of all observers. The distribution of image quality for all images in this study was assessed with open-sourced software. RESULTS:Manual identification was less repeatable than semi-automated correction for four of the five observers. Excellent repeatability was seen from all observers (ICC = 0.997-0.999), and there was good agreement between repeat cell identification corrections in all five observers (range: 9.43-25.71 cells/degree2). Reliability of cell identification was significantly different in two of the five observers, and worst in images taken from hibernating 13-LGS. Interocular symmetry of cone density was seen in the five 13-LGS assessed. Image quality was variable between blur- and pixel intensity-based metrics. CONCLUSIONS:Interocular symmetry with repeatable cone density measurements suggest that the 13-LGS is well-suited for longitudinal examination of the cone mosaic using split-detection AOSLO. Differences in reliability highlight the importance of observer training and automation of AOSLO cell detection. Cone density measurements from hibernating 13-LGS are not repeatable. Additional studies are warranted to assess other metrics of cone health to detect deviations from normal 13-LGS in future models of cone disorder in this species.

Dataset Information

Interobserver and intraobserver variations in radial head fracture classification-assessment of two classification systems.

Publications

Interobserver and intraobserver variations in radial head fracture classification-assessment of two classification systems.

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