INTEROBSERVER AND INTRAOBSERVER VARIABILITY IN THE C-EOS. COMPARISON BETWEEN EXPERIENCED SPINE SURGEONS AND TRAINEES. María del Mar Pozo-Balado, PhD José.

Slides:

Advertisements

Similar presentations

Evaluating the Reliability and Validity of the Family Conference OSCE Across Multiple Training Sites Jeffrey G. Chipman MD, Constance C. Schmitz PhD, Travis.

Advertisements

Justin Roe, Justin Webb, Lucy Salmon

The Epidemiology and Prognosis of Bilateral Legg-Calve-Perthes Disease :A comparative study with unilateral LCPD Sung-Taek Jung, Ju-Kwon Park, Nam-Young.

The Safety and Effectiveness of Convex Anterior and Posterior Hemiepiphysiodesis for the Treatment of Congenital Scoliosis Andrew Thome, Jr. 1, Roshan.

Intraobserver and Interobserver Reliability of the Classification of Thoracic Adolescent Idiopathic Scoliosis*† by LAWRENCE G. LENKE, RANDAL R. BETZ, KEITH.

A comprehensive clinical impact classification of Adult Scoliosis

F Schwab 1,2, JP Farcy 1,2, K Bridwell 2, S Berven 2, S Glassman 2,

Utility of Collateral Informants to Inform Treatment for Gambling Disorder Megan M. Petra, MSW Renee M. Cunningham-Williams, PhD.

Ankle fractures have features of an osteoporotic fracture Kyoung Min Lee MD Department of Orthopaedic Surgery Seoul National University Bundang Hospital.

Quantifying of avascular necrosis of femoral head The clinical problem Determining the risk of femoral head collapse in a patient with AVNFH.

Introduction Patients with tumors affecting the spine have significant impairments in Quality of Life domains that include physical function, neural function,

Surgery of Spinal Deformities Rizzoli Orthopaedic Institute Bologna, Italy Surgical options in progressive scoliosis in pediatric patients with Neurofibromatosis.

Results of Preoperative Pulmonary Function Testing of Adolescents with Idiopathic Scoliosis by Peter O. Newton, Frances D. Faro, Sohrab Gollogly, Randal.

RESULTS INTRODUCTION Laurentian_University.svgLaurentian_University.svg‎ (SVG file, nominally 500 × 87 pixels, file size: 57 KB) Comparison of the ASQ.

Analysis of Intra-observer's Repeatability in Retinopathy's Classification of patients with, both, Clear and Yellow IOL's implantation INTRODUCTION METHODS.

Rotational Profile of the Lower Extremity in Achondroplasia : Computed Tomographic Examination of 25 patients Hae-Ryong Song, M.D., Keny Swapnil.M M.S,

Comparison of the Volume of Scoliosis Surgery Between Spine and Pediatric Orthopaedic Fellowship-Trained Surgeons in New York and California by Mark A.

Inter-rater reliability in the KPG exams The Writing Production and Mediation Module.

Interobserver Reliability and Intraobserver Reproducibility of the System of King et al. for the Classification of Adolescent Idiopathic Scoliosis* by.

Interobserver Reliability of Acute Kidney Injury Network (AKIN) criteria A single center cohort study Figure 2 The acute kidney injury network (AKIN) criteria.

Do continuity and co-ordination of care influence quality of care and health outcomes? Stephen Campbell, David Reeves, Elizabeth Middleton, Martin Roland.

Secondary Thoracic Insufficiency Syndrome in None Ambulatory Myelodisplastic Children.

In the first 5 years of Treatment, the Charges for Guided Growth Constructs are 30% less than Growing Rods Lindsay M. Andras MD 1, Liam Harris BS 1, Scott.

Inter-rater Reliability of Clinical Ratings: A Brief Primer on Kappa Daniel H. Mathalon, Ph.D., M.D. Department of Psychiatry Yale University School of.

Classification of Early Onset Scoliosis (C-EOS) Has Almost Perfect Inter and Intra Observer Reliability Micaela Cyr, BA Tricia St. Hilaire, MPH Zhaoxing.

Reliability and validity of the adapted Spanish version of the Early Onset Scoliosis-24 questionnaire María del Mar Pozo-Balado, PhD Hiroko Matsumoto PhD.

Comparison of deformity correction and complications with VEPTR and early primary posterior spinal fusion in young children with idiopathic scoliosis:

Intra-wound Vancomycin Powder Significantly Reduces the Risk of Infection in Growth-friendly Surgery John T. Smith, MD Justin Haller, MD Angela Presson,

John T. Wilkinson m. d. , Chad E. Songy m. d. , Frances l

Inter-observer variation can be measured in any situation in which two or more independent observers are evaluating the same thing Kappa is intended to.

ICEOS 2015 Comparison of Weight Percentile Gain with Growth-Friendly Constructs in Early Onset Scoliosis Liam Harris BS1, Lindsay M Andras MD1, Paul D.

Incidence of Proximal junctional kyphosis with Magnetic Expansion Control Rods in early onset scoliosis P Inaparthy, JC Queruz, C Thakar, D Rolton, C Nnadi.

Correlation between Head Position and Trunk Shift in Congenital Cervicothoracic Junctional Deformities Michael Ruf, Attallah Hassanain, Lynn Letko, Tobias.

Postoperative Assessment of Rotator Cuff Integrity by Ultrasonography (US) in Comparison with Magnetic Resonance Imaging (MRI) P Collin ; M yoshida; T.

Should it be viewed as a single entity? Hypersensitivity pneumonitis Should it be viewed as a single entity? Venerino Poletti versus Athol Wells.

OBJECTIVE INTRODUCTION Emergency Medicine Milestones: Longitudinal Interrater Agreement EM milestones were developed by EM experts for the Accreditation.

1 Measuring Agreement. 2 Introduction Different types of agreement Diagnosis by different methods  Do both methods give the same results? Disease absent.

Oral Health Training & Calibration Programme

CLINICAL SIGNIFICANCE

Swamy Kurra Stephen Albanese Patrick Cahill Randal Betz

ICEOS 2016 Utrecht, November 2016

McWilliams DJ, Atkins G, Hodson J, Boyers M, Lea T, Snelson C

VEPTR Implantation for Children with congenital scoliosis under Age 3

DISCREPANCY BETWEEN PROGRAMMED AND OBSERVED DISTRACTIONS IN MAGNETICALLY-CONTROLLED GROWING ROD TREATED PATIENTS María del Mar Pozo-Balado, PhD; Noelia.

Retrospective Review of Shoulder Balance Comparing Adolescent Idiopathic Scoliosis (AIS) to Early Onset Scoliosis (EOS) Patrick J. Cahill William Lavelle.

Sumeet Garg, MD Jack Flynn, MD Nicole Michael, BA

Growth Friendly Surgery is Effective at Treating Scoliosis Associated with Goldenhar Syndrome Braydon Connell, Jonathan Oore, Joshua Pahys, George Thompson,

Measures of Agreement Dundee Epidemiology and Biostatistics Unit

Nicole Michael, BA John Smith, MD Tricia St. Hilaire, MPH

Radiographic Prevalence of Concomitant Scaphotrapezial Arthritis with Thumb Carpometacarpal Arthritis (Abstract # 8192) Deana Mercer, MD; Charlotte Orr,

2D/3D EOS imaging versus standing long leg x-ray in lower limb clinical assessment - inter-observer and intra-observer reliability Melinda Hau, Dipen Menon,

The Effect of the Fixed Sagittal Plane caused by Spinal Instrumentation at an Early Age on the Natural Evolution of Pelvic Incidence During Growth Bekmez.

PELVIC OBLIQUITY CONTROL IN CHILDREN WITH NEUROMUSCULAR EARLY ONSET SCOLIOSIS TREATED WITH MAGNETICALLY-CONTROLLED GROWING RODS María del Mar Pozo-Balado,

Brian Yang BA, Jill Larson MD, Michael Glotzbecker MD

Natalie Robinson Centre for Evidence-based Veterinary Medicine

G. Redding. V. Bompadre, R. DiBlasi, W. Krengel III, K. White

Baseline and Serial Brain Natriuretic Peptide Level Predicts 5-Year Overall Survival in Patients With Pulmonary Arterial Hypertension: Data From the REVEAL.

Early Experience of Frequent Small Increments Lengthening of Magnetic Spinal Growing Rods in Children with Severe Early Onset Scoliosis Joseph Ivan Krajbich.

E-Poster 159 VEPTR Implantation to Treat Children with Early Onset Scoliosis without Rib Abnormalities: A Prospective Multicenter Study Ron El-Hawary,

Good morning, ladies and gentlemen. Please let me introduce myself

UOG Journal Club: March 2012

M. Ormond, H. McParland, A. N. A. Donaldson, M. Andiappan, R. J

Analysis of Percentile Weight Changes in Failure To Thrive Children undergoing Growing Rod Insertion. ICEOS 2012 Walsh A, Lui DF, Kelly M, O'Neill F, McDevitt.

Outcome Measures in Early Onset Scoliosis

Charles E. Johnston, MD Anna McClung BSN, RN Scott Paradise

B Ilharreborde, S Moreau, K Mazda

Klane K. White, MD, MSc Viviana Bompadre, PhD Adam J. Kreutzer

Reliability analysis for Cobb angle measurements of congenital scoliosis using X ray and 3D-CT Ryoji Tauchi1), Taichi Tsuji2) , Toshiki Saito2) , Ayato.

Modifications on cervical spine sagittal alignment after magnetic growing rod instrumentation. Is there a correlation with proximal giunctional kyphosis?

The Classification for Early-Onset Scoliosis (C-EOS) Predicts Timing of VEPTR Anchor Failure Michael G. Vitale, MD MPH Associate Chief, Division of.

Presentation transcript:

INTEROBSERVER AND INTRAOBSERVER VARIABILITY IN THE C-EOS. COMPARISON BETWEEN EXPERIENCED SPINE SURGEONS AND TRAINEES. María del Mar Pozo-Balado, PhD José María López-Puerta, MD Marco Antonio Pérez-Gañán, MD David M Farrington, MD

INTRODUCTION Describe and group patients to guide optimal care and prognosticate outcomes within Early Onset Scoliosis (EOS) children. Substantial to excellent inter-observer reliability has been demonstrated in experienced surgeons.  Early Onset Scoliosis Classification System (C-EOS) Intra-observer reproducibility and Intra- and inter-observer reproducibility by clinicians with different level of expertise.  However, in order to expand it use, it must also show…

OBJECTIVE To demonstrate that C-EOS classification is a highly reliable comparison tool in EOS patients regardless of the reviewers level of training.

PATIENTS AND METHODS I Agreement study. Two expert spine orthopedic surgeons and two senior year orthopedic residents comparison of 81 cases of EOS classified according to the C-EOS classification on two separate occasions.  Study Design  C-EOS classification Williams BA, et al., J Bone Surg Am. 2014

PATIENTS AND METHODS II  Inter-observer agreement. Comparison between the initial responses of all evaluators. Interclass correlation coefficients (ICC) for continuous variables (age). Kappa indexes (Ik) for categorical variables (Etiology, Cobb Angle and Kyphosis). Levels of agreement for ICC and Ik: , slight agreement; , fair agreement; , moderate agreement; , substantial agreement; , almost perfect agreement. Landis and Koch, Biometrics 1977  Patients. 81 children under 10 years old. Complete clinical data. Available radiographic studies.

PATIENTS AND METHODS III  Intra-observer agreement. Comparison between 2 evaluations of the same cases by the same evaluator, separated by 72 hours. Interclass correlation coefficients (ICC) for continuous variables (age) Kappa indexes (KI) for categorical variables (Etiology, Cobb Angle and Kyphosis). Levels of agreement for ICC and k: , slight agreement; , fair agreement; , moderate agreement; , substantial agreement; , almost perfect agreement. Landis and Koch, Biometrics 1977  Sensitivity and Specificity Sensitivity: fraction of positive cases correctly classified by the evaluators, expressed as percentages (true-positive assessments). Specificity: true-negative assessments.

RESULTS I  Demographical and Clinical data of the 81 study children. CharacteristicValue Age, median months [IQR]81 [44-107] Cobb, median angle [IQR]36 [29-55] Kiphosys, median angle [IQR]20 [15-25] Etiology n (%) Congenital37 (47.5) Idiopathic23 (28.4) Neuromuscular12 (14.8) Syndromic9 (11.1)

RESULTS II  Almost perfect intra-observer agreement variability. Classification variableExpert 1Expert 2Trainee 1Trainee 2 Age1.000* 0.983*1.000* Etiology 0.981** 0.924** 0.964** 0.982** Cobb 1.000** 0.975** 0.950** 1.000** Kyphosis 1.000** 0.931** 1.000** *ICC; **IK No significant differences were observed in the intra-observer agreement of age, ethiology, Cobb or kyphosis between experts and trainees.

RESULTS IV RESULTS III  Almost perfect inter-observer agreement variability in all cases except for etiology between experts. Classification variableExpertsTrainees Age0.999*0.983* Etiology 0.775** 0.874** Cobb 1.000** 0.950** Kyphosis 0.886** 1.000** *ICC; **IK No significant differences were observed in the inter-observer agreement of age, ethiology, Cobb or kyphosis between experts and trainees. Substantial inter-observer agreement for ethiology between experts.

RESULTS II RESULTS IV  Sensibility and Specificity rates for C-EOS classification according to the experience. EvaluatorSensibility (%)Specificity (%) Exp Exp Trainee Trainee

CONCLUSIONS Agreement between and within observers for the C-EOS Classification is very high. However, Etiology variable shows lower agreement than the rest of variables.