Inter-observer variation in the diagnosis of coronal articular fracture lines in the lunate facet of the distal radius

Wijffels, Mathieu M E; Guitton, Thierry G.; Ring, David

doi:10.1007/s11552-012-9421-5

Cited by 7 publications

(4 citation statements)

References 13 publications

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“…Classifications were compared using the two-sample Z -test, and p values of <0.050 were considered significant [ 2 , 4 , 6 , 7 , 10 – 14 , 20 , 32 , 36 ]. A Z -test was also used to compare subgroups.…”

Section: Methodsmentioning

confidence: 99%

Reliability of classification for post-traumatic ankle osteoarthritis

Claessen

Meijer²,

Bekerom

et al. 2015

Knee Surg Sports Traumatol Arthrosc

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Purpose The purpose of this study was to identify the most reliable classification system for clinical outcome studies to categorize post-traumatic—fracture—osteoarthritis.MethodsA total of 118 orthopaedic surgeons and residents—gathered in the Ankle Platform Study Collaborative Science of Variation Group—evaluated 128 anteroposterior and lateral radiographs of patients after a bi- or trimalleolar ankle fracture on a Web-based platform in order to rate post-traumatic osteoarthritis according to the classification systems coined by (1) van Dijk, (2) Kellgren, and (3) Takakura. Reliability was evaluated with the use of the Siegel and Castellan’s multirater kappa measure. Differences between classification systems were compared using the two-sample Z-test. ResultsInterobserver agreement of surgeons who participated in the survey was fair for the van Dijk osteoarthritis scale (k = 0.24), and poor for the Takakura (k = 0.19) and the Kellgren systems (k = 0.18) according to the categorical rating of Landis and Koch. This difference in one categorical rating was found to be significant (p < 0.001, CI 0.046–0.053) with the high numbers of observers and cases available.ConclusionsThis study documents fair interobserver agreement for the van Dijk osteoarthritis scale, and poor interobserver agreement for the Takakura and Kellgren osteoarthritis classification systems. Because of the low interobserver agreement for the van Dijk, Kellgren, and Takakura classification systems, those systems cannot be used for clinical decision-making.Level of evidenceDevelopment of diagnostic criteria on basis of consecutive patients, Level II.Electronic supplementary materialThe online version of this article (doi:10.1007/s00167-015-3871-6) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Reliability of classification for post-traumatic ankle osteoarthritis

Claessen

Meijer²,

Bekerom

et al. 2015

Knee Surg Sports Traumatol Arthrosc

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“…To compare the reliability between the classifications, a 2-sample Z test was performed for the k comparison. 5,6,42,49 Univariate logistic regression analysis was performed to identify the relationship between each classification grade and the presence of subscapularis retear on 6-month follow-up MRI. Then, according to a receiver operating characteristic curve, the cutoff point for the particular grade of fatty infiltration related to the occurrence of a retear was determined for each classification scheme.…”

Section: Discussionmentioning

confidence: 99%

“…To compare the reliability between the classifications, a 2-sample Z test was performed for the κ comparison. 5,6,42,49…”

Section: Methodsmentioning

confidence: 99%

Comparison of the Goutallier Classification of Fatty Infiltration for the Subscapularis With a Novel Modified Classification

Yoon

Kim

Choi

et al. 2023

Orthopaedic Journal of Sports Medicine

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Background: Fatty infiltration in the subscapularis muscle extends to the upper portion of the muscle first and then to the lower portion only after some degree of fatty change has taken place in the upper region. Although the Goutallier classification is the most widely used method to categorize fatty infiltration, how to accurately and reliably determine the extent of infiltration is controversial. Purpose: To examine a modified classification that is more reliable in (1) assessing fatty infiltration of the subscapularis muscle and (2) predicting the structural integrity of the repaired tendon by identifying cutoff points for retear. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: This study retrospectively examined the records of 545 patients who underwent arthroscopic repair for a subscapularis tear. Two shoulder surgeons reviewed the preoperative magnetic resonance imaging scans of all enrolled patients and evaluated the fatty infiltration of the subscapularis muscle based on the original Goutallier classification, as well as a novel modified Goutallier classification designed to measure the proportion of fat and muscle in the upper and lower portions of the muscle separately. Intra- and interobserver agreement of the reviewers was calculated using κ statistics. Using receiver operating characteristic curve analysis, we determined the cutoff point for the particular fatty infiltration grade related to the occurrence of retear for each classification scheme. Results: The κ values for interobserver reliability were 0.743 and 0.856 for the original and modified Goutallier classifications, respectively, with the modified classification having significantly higher reliability ( Z = 4.064; P < .001). Cutoff points for the fatty infiltration grade associated with retear were 2.5 for the original Goutallier classification (sensitivity, 65.3%; specificity, 95.6%; accuracy, 87.8%) and 3.5 for the modified classification (sensitivity, 52.5%; specificity, 97.8%; accuracy, 89.7%). Conclusion: In assessing fatty infiltration of the subscapularis muscle, the modified Goutallier classification showed higher reliability than the original Goutallier classification. The cutoff point for potential retear (grade 3.5) was at a point where the fatty infiltration extended to the lower portion of the subscapularis muscle.

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“…29,37 We compared staging systems and subgroups using the Z test, as previously described by our group. 5,6,11,12,[14][15][16][17][18]32,40,42,45 Results Participants Twenty-six of the 32 observers supervised surgical trainees, and 62% were in practice 6 years or more. Demographics of the observers are reported in Table I.…”

Section: Discussionmentioning

confidence: 99%