A Clavé1, L Tristan2, A Desseaux2, F Gaucher3, C Lefèvre4, E Stindel4. 1. Université de Bretagne Occidentale, faculté de médecine, 22, avenue Camille-Desmoulins, 29200 Brest, France; Service de chirurgie orthopédique et traumatologique de la Cavale-Blanche, boulevard Tanguy-Prigent, 29609 Brest cedex, France; LaTIM, Inserm UMR 1101, 2, avenue Foch, 29609 Brest cedex, France. Electronic address: arnaud.clave@orange.fr. 2. Université de Bretagne Occidentale, faculté de médecine, 22, avenue Camille-Desmoulins, 29200 Brest, France; Service de chirurgie orthopédique et traumatologique de la Cavale-Blanche, boulevard Tanguy-Prigent, 29609 Brest cedex, France. 3. Centre hospitalier de Cornouaille, 14, avenue Thépot, BP 1757, 29107 Quimper cedex, France. 4. Université de Bretagne Occidentale, faculté de médecine, 22, avenue Camille-Desmoulins, 29200 Brest, France; Service de chirurgie orthopédique et traumatologique de la Cavale-Blanche, boulevard Tanguy-Prigent, 29609 Brest cedex, France; LaTIM, Inserm UMR 1101, 2, avenue Foch, 29609 Brest cedex, France.
Abstract
INTRODUCTION: A previous study demonstrated that the reproducibility of the Crowe (Cr), the Hartofilakidis (Ha) and the modified Cochin (Co) classifications were comparable. However, there were differences with a trend that suggested the influence of experience. Therefore, we performed a prospective study to investigate whether experience influenced the reproducibility of the commonly used developmental dysplasia of the hip (DDH) classifications. HYPOTHESIS: The hypothesis was that the intra- and inter-observer reproducibility scores would be higher in the senior group than the junior group, and particularly for the modified Co classification. METHODS: Four seniors and four residents classified 104 A/P pelvic radiographs (200 hips) two times using the Cr, Ha and Co classification systems. RESULTS: For intra-observer reproducibility, the average weighted concordance coefficients [95% confidence intervals] were for the senior and the junior groups: 92.2 [88.6-95.7] and 92.6 [87.9-97.2] for Cr, 92.1 [88.7-94.6] and 92.0 [87.7-96.3] for Ha, 94.2 [91.8-96.6] and 94.1 [91.5-96.6] for Co. The average weighted Kappa (95% confidence intervals) were 0.8 [0.71-0.88] and 0.79 [0.68-0.89] for Cr, 0.77 [0.74-0.81] and 0.75 [0.62-0.88] for Ha, 0.82 [0.76-0.89] and 0.80 [0.74-0.87] for Co. The junior inter-observer reproducibility multi-rater Kappa (list A:list B) were 0.57:0.50 (Cr), 0.47:0.53 (Ha), 0.42:0.42 (Co). Senior multi-rater Kappa were 0.53:0.49 (Cr), 0.40:0.34 (Ha), 0.40:0.43 (Co). CONCLUSIONS: Contrary to our hypothesis, the experience of the observer did not affect the intra- and inter-observer reproducibility of the three classification systems.
INTRODUCTION: A previous study demonstrated that the reproducibility of the Crowe (Cr), the Hartofilakidis (Ha) and the modified Cochin (Co) classifications were comparable. However, there were differences with a trend that suggested the influence of experience. Therefore, we performed a prospective study to investigate whether experience influenced the reproducibility of the commonly used developmental dysplasia of the hip (DDH) classifications. HYPOTHESIS: The hypothesis was that the intra- and inter-observer reproducibility scores would be higher in the senior group than the junior group, and particularly for the modified Co classification. METHODS: Four seniors and four residents classified 104 A/P pelvic radiographs (200 hips) two times using the Cr, Ha and Co classification systems. RESULTS: For intra-observer reproducibility, the average weighted concordance coefficients [95% confidence intervals] were for the senior and the junior groups: 92.2 [88.6-95.7] and 92.6 [87.9-97.2] for Cr, 92.1 [88.7-94.6] and 92.0 [87.7-96.3] for Ha, 94.2 [91.8-96.6] and 94.1 [91.5-96.6] for Co. The average weighted Kappa (95% confidence intervals) were 0.8 [0.71-0.88] and 0.79 [0.68-0.89] for Cr, 0.77 [0.74-0.81] and 0.75 [0.62-0.88] for Ha, 0.82 [0.76-0.89] and 0.80 [0.74-0.87] for Co. The junior inter-observer reproducibility multi-rater Kappa (list A:list B) were 0.57:0.50 (Cr), 0.47:0.53 (Ha), 0.42:0.42 (Co). Senior multi-rater Kappa were 0.53:0.49 (Cr), 0.40:0.34 (Ha), 0.40:0.43 (Co). CONCLUSIONS: Contrary to our hypothesis, the experience of the observer did not affect the intra- and inter-observer reproducibility of the three classification systems.
Authors: Julio Urrutia; Pablo Besa; Sergio Morales; Antonio Parlange; Sebastian Flores; Mauricio Campos; Sebastian Mobarec Journal: Eur Spine J Date: 2018-07-11 Impact factor: 3.134