Repeatability and Intra- and Inter-observer Agreement of Cervical Vertebral Sagittal Diameter Ratios in Horses with Neurological Disease

Background Sagittal ratio values (SRVs) of cervical vertebrae are used for ante‐mortem diagnosis of cervical vertebral stenotic myelopathy, but intraobserver and interobserver variability in measurement may influence radiographic interpretation of vertebral stenosis in horses with neurological disea...

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Veröffentlicht in:Journal of veterinary internal medicine 2014-11, Vol.28 (6), p.1860-1870
Hauptverfasser: Hughes, K.J., Laidlaw, E.H., Reed, S.M., Keen, J., Abbott, J.B., Trevail, T., Hammond, G., Parkin, T.D.H., Love, S.
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container_end_page 1870
container_issue 6
container_start_page 1860
container_title Journal of veterinary internal medicine
container_volume 28
creator Hughes, K.J.
Laidlaw, E.H.
Reed, S.M.
Keen, J.
Abbott, J.B.
Trevail, T.
Hammond, G.
Parkin, T.D.H.
Love, S.
description Background Sagittal ratio values (SRVs) of cervical vertebrae are used for ante‐mortem diagnosis of cervical vertebral stenotic myelopathy, but intraobserver and interobserver variability in measurement may influence radiographic interpretation of vertebral stenosis in horses with neurological disease. Objectives To determine intraobserver repeatability in SRVs, intra‐ and interobserver agreement in SRVs and whether or not agreement was influenced by animal age. Animals Forty‐two horses (>1 year old) with neurological disease from which laterolateral computed radiographic images of C2–C7 were obtained. Methods Four observers made measurements from C2 to C7 for each horse and interobserver agreement for intra‐ and intervertebral SRVs was determined using Bland–Altman analysis (acceptable agreement: limits of agreement [LOA] ≤ 0.05) on all horses and those ≤3 (n = 25) and >3 (n = 17) years old. Each observer also made repeated measurements for 10 horses and intraobserver repeatability and agreement were determined. Results Adequate intraobserver repeatability was achieved for 6 sites. Within observers, paired measurements had a median difference ≤5.7%, but a large range in differences often occurred, most frequently at intervertebral sites. For C5, C6, C7, and C3–4, LOA ≤ 0.05 were achieved by at least 1 observer. With the exception of C5 for 1 pair, LOA were >0.05 for interobserver agreement, regardless of animal age. LOA were largest at intervertebral sites. Conclusions and Clinical Importance Within and between observers, measurement error may limit the diagnostic accuracy of SRVs and result in discrepancies of diagnosis and treatment and warrants consideration when used clinically in horses with neurological disease.
doi_str_mv 10.1111/jvim.12431
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Objectives To determine intraobserver repeatability in SRVs, intra‐ and interobserver agreement in SRVs and whether or not agreement was influenced by animal age. Animals Forty‐two horses (&gt;1 year old) with neurological disease from which laterolateral computed radiographic images of C2–C7 were obtained. Methods Four observers made measurements from C2 to C7 for each horse and interobserver agreement for intra‐ and intervertebral SRVs was determined using Bland–Altman analysis (acceptable agreement: limits of agreement [LOA] ≤ 0.05) on all horses and those ≤3 (n = 25) and &gt;3 (n = 17) years old. Each observer also made repeated measurements for 10 horses and intraobserver repeatability and agreement were determined. Results Adequate intraobserver repeatability was achieved for 6 sites. Within observers, paired measurements had a median difference ≤5.7%, but a large range in differences often occurred, most frequently at intervertebral sites. For C5, C6, C7, and C3–4, LOA ≤ 0.05 were achieved by at least 1 observer. With the exception of C5 for 1 pair, LOA were &gt;0.05 for interobserver agreement, regardless of animal age. LOA were largest at intervertebral sites. Conclusions and Clinical Importance Within and between observers, measurement error may limit the diagnostic accuracy of SRVs and result in discrepancies of diagnosis and treatment and warrants consideration when used clinically in horses with neurological disease.</description><identifier>ISSN: 0891-6640</identifier><identifier>EISSN: 1939-1676</identifier><identifier>DOI: 10.1111/jvim.12431</identifier><identifier>PMID: 25410955</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Age Factors ; Animals ; Cervical Vertebrae - diagnostic imaging ; Cervical Vertebrae - pathology ; Equine ; Female ; Horse Diseases - diagnosis ; Horse Diseases - diagnostic imaging ; Horse Diseases - pathology ; Horses ; Humans ; Male ; Measurement error ; Nervous System Diseases - diagnosis ; Nervous System Diseases - diagnostic imaging ; Nervous System Diseases - pathology ; Nervous System Diseases - veterinary ; Observer Variation ; Radiography ; Reproducibility of Results ; Spinal Stenosis - diagnosis ; Spinal Stenosis - diagnostic imaging ; Spinal Stenosis - pathology ; Spinal Stenosis - veterinary ; Ultrasonic imaging</subject><ispartof>Journal of veterinary internal medicine, 2014-11, Vol.28 (6), p.1860-1870</ispartof><rights>Copyright © 2014 by the American College of Veterinary Internal Medicine</rights><rights>Copyright © 2014 by the American College of Veterinary Internal Medicine.</rights><rights>2014. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). 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Objectives To determine intraobserver repeatability in SRVs, intra‐ and interobserver agreement in SRVs and whether or not agreement was influenced by animal age. Animals Forty‐two horses (&gt;1 year old) with neurological disease from which laterolateral computed radiographic images of C2–C7 were obtained. Methods Four observers made measurements from C2 to C7 for each horse and interobserver agreement for intra‐ and intervertebral SRVs was determined using Bland–Altman analysis (acceptable agreement: limits of agreement [LOA] ≤ 0.05) on all horses and those ≤3 (n = 25) and &gt;3 (n = 17) years old. Each observer also made repeated measurements for 10 horses and intraobserver repeatability and agreement were determined. Results Adequate intraobserver repeatability was achieved for 6 sites. Within observers, paired measurements had a median difference ≤5.7%, but a large range in differences often occurred, most frequently at intervertebral sites. For C5, C6, C7, and C3–4, LOA ≤ 0.05 were achieved by at least 1 observer. With the exception of C5 for 1 pair, LOA were &gt;0.05 for interobserver agreement, regardless of animal age. LOA were largest at intervertebral sites. 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Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of veterinary internal medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>Hughes, K.J.</au><au>Laidlaw, E.H.</au><au>Reed, S.M.</au><au>Keen, J.</au><au>Abbott, J.B.</au><au>Trevail, T.</au><au>Hammond, G.</au><au>Parkin, T.D.H.</au><au>Love, S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Repeatability and Intra- and Inter-observer Agreement of Cervical Vertebral Sagittal Diameter Ratios in Horses with Neurological Disease</atitle><jtitle>Journal of veterinary internal medicine</jtitle><addtitle>J Vet Intern Med</addtitle><date>2014-11</date><risdate>2014</risdate><volume>28</volume><issue>6</issue><spage>1860</spage><epage>1870</epage><pages>1860-1870</pages><issn>0891-6640</issn><eissn>1939-1676</eissn><abstract>Background Sagittal ratio values (SRVs) of cervical vertebrae are used for ante‐mortem diagnosis of cervical vertebral stenotic myelopathy, but intraobserver and interobserver variability in measurement may influence radiographic interpretation of vertebral stenosis in horses with neurological disease. Objectives To determine intraobserver repeatability in SRVs, intra‐ and interobserver agreement in SRVs and whether or not agreement was influenced by animal age. Animals Forty‐two horses (&gt;1 year old) with neurological disease from which laterolateral computed radiographic images of C2–C7 were obtained. Methods Four observers made measurements from C2 to C7 for each horse and interobserver agreement for intra‐ and intervertebral SRVs was determined using Bland–Altman analysis (acceptable agreement: limits of agreement [LOA] ≤ 0.05) on all horses and those ≤3 (n = 25) and &gt;3 (n = 17) years old. Each observer also made repeated measurements for 10 horses and intraobserver repeatability and agreement were determined. Results Adequate intraobserver repeatability was achieved for 6 sites. Within observers, paired measurements had a median difference ≤5.7%, but a large range in differences often occurred, most frequently at intervertebral sites. For C5, C6, C7, and C3–4, LOA ≤ 0.05 were achieved by at least 1 observer. With the exception of C5 for 1 pair, LOA were &gt;0.05 for interobserver agreement, regardless of animal age. LOA were largest at intervertebral sites. Conclusions and Clinical Importance Within and between observers, measurement error may limit the diagnostic accuracy of SRVs and result in discrepancies of diagnosis and treatment and warrants consideration when used clinically in horses with neurological disease.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>25410955</pmid><doi>10.1111/jvim.12431</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record>
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source Wiley Online Library (Open Access Collection)
subjects Age Factors
Animals
Cervical Vertebrae - diagnostic imaging
Cervical Vertebrae - pathology
Equine
Female
Horse Diseases - diagnosis
Horse Diseases - diagnostic imaging
Horse Diseases - pathology
Horses
Humans
Male
Measurement error
Nervous System Diseases - diagnosis
Nervous System Diseases - diagnostic imaging
Nervous System Diseases - pathology
Nervous System Diseases - veterinary
Observer Variation
Radiography
Reproducibility of Results
Spinal Stenosis - diagnosis
Spinal Stenosis - diagnostic imaging
Spinal Stenosis - pathology
Spinal Stenosis - veterinary
Ultrasonic imaging
title Repeatability and Intra- and Inter-observer Agreement of Cervical Vertebral Sagittal Diameter Ratios in Horses with Neurological Disease
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