Measurement of the Center Edge Angle and Determination of the Severin Classification Using Digital Radiography, Computer-assisted Measurement Tools, and a Severin Algorithm: Intraobserver and Interobserver Reliability Revisited
BACKGROUNDNumerous studies underscore the poor intraobserver and interobserver reliability of both the center edge angle (CEA) and the Severin classification using plain film measurements. In this study, experienced observers applied a computer-assisted measurement program to determine the CEA in di...
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| Veröffentlicht in: | Journal of pediatric orthopaedics 2011-06, Vol.31 (4), p.e30-e35 |
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| creator | Carroll, Kristen L Murray, Kathleen A MacLeod, Lynne M Hennessey, Theresa A Woiczik, Marcella R Roach, James W |
| description | BACKGROUNDNumerous studies underscore the poor intraobserver and interobserver reliability of both the center edge angle (CEA) and the Severin classification using plain film measurements. In this study, experienced observers applied a computer-assisted measurement program to determine the CEA in digital pelvic radiographs of adults who had been previously treated for dysplasia of the hip (DDH). Using a teaching aid/algorithm of the Severin classification, the observers then assigned a Severin rating to these hips. Intraobserver and interobserver errors were then calculated on both the CEA measurements and the Severin classifications.
METHODSFour pediatric orthopaedic surgeons and 1 pediatric radiologist calculated the CEAs using the OrthoView TM planning system and then determined the Severin classification on 41 blinded digital pelvic radiographs. The radiographs were evaluated by each examiner twice, with evaluations separated by 2 months. All examiners reviewed a Severin classification algorithm before making their Severin assignments. The intraobserver and interobserver reliability for both the CEA and the Severin classification were calculated using the interclass correlation coefficients and Cohen and Fleiss κ scores, respectively.
RESULTSThe intraobserver and interobserver reliability for CEA measurement was moderate to almost perfect. When we separated the Severin classification into 3 clinically relevant groups of good (Severin I and II), dysplastic (Severin III), and poor (Severin IV and above), our interobserver reliability neared almost perfect.
CONCLUSIONThe Severin classification is an extremely useful and oft-used radiographic measure for the success of DDH treatment. Our research found digital radiography, computer-aided measurement tools, the use of a Severin algorithm, and separating the Severin classification into 3 clinically relevant groups significantly increased the intraobserver and interobserver reliability of both the CEA and Severin classification. This finding will assist future studies using the CEA and Severin classification in the radiographic assessment of DDH treatment outcomes.
LEVEL OF EVIDENCEDiagnostic Studies-Investigating a Diagnostic Test, Level 1 |
| doi_str_mv | 10.1097/BPO.0b013e31821adde9 |
| format | Article |
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METHODSFour pediatric orthopaedic surgeons and 1 pediatric radiologist calculated the CEAs using the OrthoView TM planning system and then determined the Severin classification on 41 blinded digital pelvic radiographs. The radiographs were evaluated by each examiner twice, with evaluations separated by 2 months. All examiners reviewed a Severin classification algorithm before making their Severin assignments. The intraobserver and interobserver reliability for both the CEA and the Severin classification were calculated using the interclass correlation coefficients and Cohen and Fleiss κ scores, respectively.
RESULTSThe intraobserver and interobserver reliability for CEA measurement was moderate to almost perfect. When we separated the Severin classification into 3 clinically relevant groups of good (Severin I and II), dysplastic (Severin III), and poor (Severin IV and above), our interobserver reliability neared almost perfect.
CONCLUSIONThe Severin classification is an extremely useful and oft-used radiographic measure for the success of DDH treatment. Our research found digital radiography, computer-aided measurement tools, the use of a Severin algorithm, and separating the Severin classification into 3 clinically relevant groups significantly increased the intraobserver and interobserver reliability of both the CEA and Severin classification. This finding will assist future studies using the CEA and Severin classification in the radiographic assessment of DDH treatment outcomes.
LEVEL OF EVIDENCEDiagnostic Studies-Investigating a Diagnostic Test, Level 1</description><identifier>ISSN: 0271-6798</identifier><identifier>EISSN: 1539-2570</identifier><identifier>DOI: 10.1097/BPO.0b013e31821adde9</identifier><identifier>PMID: 21572269</identifier><language>eng</language><publisher>United States: Lippincott Williams & Wilkins, Inc</publisher><subject>Adolescent ; Adult ; Algorithms ; Follow-Up Studies ; Hip Dislocation, Congenital - classification ; Hip Dislocation, Congenital - diagnostic imaging ; Hip Dislocation, Congenital - surgery ; Humans ; Middle Aged ; Observer Variation ; Radiographic Image Interpretation, Computer-Assisted - methods ; Reproducibility of Results ; Treatment Outcome ; Young Adult</subject><ispartof>Journal of pediatric orthopaedics, 2011-06, Vol.31 (4), p.e30-e35</ispartof><rights>2011 Lippincott Williams & Wilkins, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21572269$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Carroll, Kristen L</creatorcontrib><creatorcontrib>Murray, Kathleen A</creatorcontrib><creatorcontrib>MacLeod, Lynne M</creatorcontrib><creatorcontrib>Hennessey, Theresa A</creatorcontrib><creatorcontrib>Woiczik, Marcella R</creatorcontrib><creatorcontrib>Roach, James W</creatorcontrib><title>Measurement of the Center Edge Angle and Determination of the Severin Classification Using Digital Radiography, Computer-assisted Measurement Tools, and a Severin Algorithm: Intraobserver and Interobserver Reliability Revisited</title><title>Journal of pediatric orthopaedics</title><addtitle>J Pediatr Orthop</addtitle><description>BACKGROUNDNumerous studies underscore the poor intraobserver and interobserver reliability of both the center edge angle (CEA) and the Severin classification using plain film measurements. In this study, experienced observers applied a computer-assisted measurement program to determine the CEA in digital pelvic radiographs of adults who had been previously treated for dysplasia of the hip (DDH). Using a teaching aid/algorithm of the Severin classification, the observers then assigned a Severin rating to these hips. Intraobserver and interobserver errors were then calculated on both the CEA measurements and the Severin classifications.
METHODSFour pediatric orthopaedic surgeons and 1 pediatric radiologist calculated the CEAs using the OrthoView TM planning system and then determined the Severin classification on 41 blinded digital pelvic radiographs. The radiographs were evaluated by each examiner twice, with evaluations separated by 2 months. All examiners reviewed a Severin classification algorithm before making their Severin assignments. The intraobserver and interobserver reliability for both the CEA and the Severin classification were calculated using the interclass correlation coefficients and Cohen and Fleiss κ scores, respectively.
RESULTSThe intraobserver and interobserver reliability for CEA measurement was moderate to almost perfect. When we separated the Severin classification into 3 clinically relevant groups of good (Severin I and II), dysplastic (Severin III), and poor (Severin IV and above), our interobserver reliability neared almost perfect.
CONCLUSIONThe Severin classification is an extremely useful and oft-used radiographic measure for the success of DDH treatment. Our research found digital radiography, computer-aided measurement tools, the use of a Severin algorithm, and separating the Severin classification into 3 clinically relevant groups significantly increased the intraobserver and interobserver reliability of both the CEA and Severin classification. This finding will assist future studies using the CEA and Severin classification in the radiographic assessment of DDH treatment outcomes.
LEVEL OF EVIDENCEDiagnostic Studies-Investigating a Diagnostic Test, Level 1</description><subject>Adolescent</subject><subject>Adult</subject><subject>Algorithms</subject><subject>Follow-Up Studies</subject><subject>Hip Dislocation, Congenital - classification</subject><subject>Hip Dislocation, Congenital - diagnostic imaging</subject><subject>Hip Dislocation, Congenital - surgery</subject><subject>Humans</subject><subject>Middle Aged</subject><subject>Observer Variation</subject><subject>Radiographic Image Interpretation, Computer-Assisted - methods</subject><subject>Reproducibility of Results</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0271-6798</issn><issn>1539-2570</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdUcFu1DAQjRCILoU_QMg3Lk0Z24kdc1vSAisVFZX2HHmTSWJw4q2dtNrv5UfwdtsFcbA8evPmvdG8JHlL4ZSCkh8-fb88hTVQjpwWjOqmQfUsWdCcq5TlEp4nC2CSpkKq4ih5FcJPACp5xl8mR4zmkjGhFsnvb6jD7HHAcSKuJVOPpIw1enLedEiWY2eR6LEhZxjBwYx6Mm58ov7AO_RmJKXVIZjW1PvuTTBjR85MZyZtyZVujOu83vTbE1K6YTNHpXQ3ECZsyL8bXDtnw8mDnz6IL23nvJn64SNZjZPXbh3Qx9YDbbXb9YBcoTV6bayZtrG-M8FEh9fJi1bbgG8e_-Pk5vP5dfk1vbj8siqXF2nNAVhaSyHqtlEcQWaYF1wXALWQEZSF4BnLatQFihoUp0AFosqFgoJjW-Qqz_hx8n6vu_HudsYwVYMJNVqrR3RzqAohOeMZQGRme2btXQge22rjzaD9tqJQ7dKtYrrV_-nGsXePBvN6wOYw9BTnX917Z-NZwi8736OvetR26iugLKNcFSkDSkEAQBofY_wPAiW2mw</recordid><startdate>201106</startdate><enddate>201106</enddate><creator>Carroll, Kristen L</creator><creator>Murray, Kathleen A</creator><creator>MacLeod, Lynne M</creator><creator>Hennessey, Theresa A</creator><creator>Woiczik, Marcella R</creator><creator>Roach, James W</creator><general>Lippincott Williams & Wilkins, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201106</creationdate><title>Measurement of the Center Edge Angle and Determination of the Severin Classification Using Digital Radiography, Computer-assisted Measurement Tools, and a Severin Algorithm: Intraobserver and Interobserver Reliability Revisited</title><author>Carroll, Kristen L ; Murray, Kathleen A ; MacLeod, Lynne M ; Hennessey, Theresa A ; Woiczik, Marcella R ; Roach, James W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3002-c766cfd93e074e583a800c676cf7863424cea8e6c0931016ee9569083ef859543</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Algorithms</topic><topic>Follow-Up Studies</topic><topic>Hip Dislocation, Congenital - classification</topic><topic>Hip Dislocation, Congenital - diagnostic imaging</topic><topic>Hip Dislocation, Congenital - surgery</topic><topic>Humans</topic><topic>Middle Aged</topic><topic>Observer Variation</topic><topic>Radiographic Image Interpretation, Computer-Assisted - methods</topic><topic>Reproducibility of Results</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Carroll, Kristen L</creatorcontrib><creatorcontrib>Murray, Kathleen A</creatorcontrib><creatorcontrib>MacLeod, Lynne M</creatorcontrib><creatorcontrib>Hennessey, Theresa A</creatorcontrib><creatorcontrib>Woiczik, Marcella R</creatorcontrib><creatorcontrib>Roach, James W</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of pediatric orthopaedics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Carroll, Kristen L</au><au>Murray, Kathleen A</au><au>MacLeod, Lynne M</au><au>Hennessey, Theresa A</au><au>Woiczik, Marcella R</au><au>Roach, James W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Measurement of the Center Edge Angle and Determination of the Severin Classification Using Digital Radiography, Computer-assisted Measurement Tools, and a Severin Algorithm: Intraobserver and Interobserver Reliability Revisited</atitle><jtitle>Journal of pediatric orthopaedics</jtitle><addtitle>J Pediatr Orthop</addtitle><date>2011-06</date><risdate>2011</risdate><volume>31</volume><issue>4</issue><spage>e30</spage><epage>e35</epage><pages>e30-e35</pages><issn>0271-6798</issn><eissn>1539-2570</eissn><abstract>BACKGROUNDNumerous studies underscore the poor intraobserver and interobserver reliability of both the center edge angle (CEA) and the Severin classification using plain film measurements. In this study, experienced observers applied a computer-assisted measurement program to determine the CEA in digital pelvic radiographs of adults who had been previously treated for dysplasia of the hip (DDH). Using a teaching aid/algorithm of the Severin classification, the observers then assigned a Severin rating to these hips. Intraobserver and interobserver errors were then calculated on both the CEA measurements and the Severin classifications.
METHODSFour pediatric orthopaedic surgeons and 1 pediatric radiologist calculated the CEAs using the OrthoView TM planning system and then determined the Severin classification on 41 blinded digital pelvic radiographs. The radiographs were evaluated by each examiner twice, with evaluations separated by 2 months. All examiners reviewed a Severin classification algorithm before making their Severin assignments. The intraobserver and interobserver reliability for both the CEA and the Severin classification were calculated using the interclass correlation coefficients and Cohen and Fleiss κ scores, respectively.
RESULTSThe intraobserver and interobserver reliability for CEA measurement was moderate to almost perfect. When we separated the Severin classification into 3 clinically relevant groups of good (Severin I and II), dysplastic (Severin III), and poor (Severin IV and above), our interobserver reliability neared almost perfect.
CONCLUSIONThe Severin classification is an extremely useful and oft-used radiographic measure for the success of DDH treatment. Our research found digital radiography, computer-aided measurement tools, the use of a Severin algorithm, and separating the Severin classification into 3 clinically relevant groups significantly increased the intraobserver and interobserver reliability of both the CEA and Severin classification. This finding will assist future studies using the CEA and Severin classification in the radiographic assessment of DDH treatment outcomes.
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Adolescent Adult Algorithms Follow-Up Studies Hip Dislocation, Congenital - classification Hip Dislocation, Congenital - diagnostic imaging Hip Dislocation, Congenital - surgery Humans Middle Aged Observer Variation Radiographic Image Interpretation, Computer-Assisted - methods Reproducibility of Results Treatment Outcome Young Adult |
| title | Measurement of the Center Edge Angle and Determination of the Severin Classification Using Digital Radiography, Computer-assisted Measurement Tools, and a Severin Algorithm: Intraobserver and Interobserver Reliability Revisited |
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