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Article: Interobserver and intraobserver variability in the identification of the lenke classification lumbar modifier in adolescent idiopathic scoliosis

TitleInterobserver and intraobserver variability in the identification of the lenke classification lumbar modifier in adolescent idiopathic scoliosis
Authors
KeywordsCurve classification
Idiopathic scoliosis
Observer variation
Issue Date2009
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.jspinaldisorders-tech.com
Citation
Journal Of Spinal Disorders And Techniques, 2009, v. 22 n. 6, p. 448-455 How to Cite?
AbstractSTUDY DESIGN: Interobserver and intraobserver reliability study for the identification of the Lenke classification lumbar modifier by a panel of experts compared with a computer algorithm. OBJECTIVES: To measure the variability of the Lenke classification lumbar modifier and determine if computer assistance using 3-dimensional spine models can improve the reliability of classification. SUMMARY OF BACKGROUND DATA: The lumbar modifier has been proposed to subclassify Lenke scoliotic curve types into A, B, and C on the basis of the relationship between the central sacral vertical line (CSVL) and the apical lumbar vertebra. Landmarks for identification of the CSVL have not been clearly defined, and the reliability of the actual CSVL position and lumbar modifier selection have never been tested independently. Therefore, the value of the lumbar modifier for curve classification remains unknown. METHODS: The preoperative radiographs of 68 patients with adolescent idiopathic scoliosis presenting a Lenke type 1 curve were measured manually twice by 6 members of the Scoliosis Research Society 3-dimensional classification committee at 6 months interval. Intraobserver and interobserver reliability was quantified using the percentage of agreement and κ statistics. In addition, the lumbar curve of all subjects was reconstructed in 3-dimension using a stereoradiographic technique and was submitted to a computer algorithm to infer the lumbar modifier according to measurements from the pedicles. RESULTS: Interobserver rates for the first trial showed a mean κ value of 0.56. Second trial rates were higher with a mean κ value of 0.64. Intraobserver rates were evaluated at a mean κ value of 0.69. The computer algorithm was successful in identifying the lumbar curve type and was in agreement with the observers by a proportion up to 93%. CONCLUSIONS: Agreement between and within observers for the Lenke lumbar modifier is only moderate to substantial with manual methods. Computer assistance with 3-dimensional models of the spine has the potential to decrease this variability. © 2009 Lippincott Williams & Wilkins, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/125199
ISSN
2015 Impact Factor: 2.291
2015 SCImago Journal Rankings: 0.798
ISI Accession Number ID
Funding AgencyGrant Number
Scoliosis Research Society
Canadian Institutes of Health Research
Funding Information:

Funded by the Scoliosis Research Society and MENTOR, a strategic training program of the Canadian Institutes of Health Research.

References

 

DC FieldValueLanguage
dc.contributor.authorDuong, Len_HK
dc.contributor.authorCheriet, Fen_HK
dc.contributor.authorLabelle, Hen_HK
dc.contributor.authorCheung, KMCen_HK
dc.contributor.authorAbel, MFen_HK
dc.contributor.authorNewton, POen_HK
dc.contributor.authorMcCall, REen_HK
dc.contributor.authorLenke, LGen_HK
dc.contributor.authorStokes, IAFen_HK
dc.date.accessioned2010-10-31T11:17:04Z-
dc.date.available2010-10-31T11:17:04Z-
dc.date.issued2009en_HK
dc.identifier.citationJournal Of Spinal Disorders And Techniques, 2009, v. 22 n. 6, p. 448-455en_HK
dc.identifier.issn1536-0652en_HK
dc.identifier.urihttp://hdl.handle.net/10722/125199-
dc.description.abstractSTUDY DESIGN: Interobserver and intraobserver reliability study for the identification of the Lenke classification lumbar modifier by a panel of experts compared with a computer algorithm. OBJECTIVES: To measure the variability of the Lenke classification lumbar modifier and determine if computer assistance using 3-dimensional spine models can improve the reliability of classification. SUMMARY OF BACKGROUND DATA: The lumbar modifier has been proposed to subclassify Lenke scoliotic curve types into A, B, and C on the basis of the relationship between the central sacral vertical line (CSVL) and the apical lumbar vertebra. Landmarks for identification of the CSVL have not been clearly defined, and the reliability of the actual CSVL position and lumbar modifier selection have never been tested independently. Therefore, the value of the lumbar modifier for curve classification remains unknown. METHODS: The preoperative radiographs of 68 patients with adolescent idiopathic scoliosis presenting a Lenke type 1 curve were measured manually twice by 6 members of the Scoliosis Research Society 3-dimensional classification committee at 6 months interval. Intraobserver and interobserver reliability was quantified using the percentage of agreement and κ statistics. In addition, the lumbar curve of all subjects was reconstructed in 3-dimension using a stereoradiographic technique and was submitted to a computer algorithm to infer the lumbar modifier according to measurements from the pedicles. RESULTS: Interobserver rates for the first trial showed a mean κ value of 0.56. Second trial rates were higher with a mean κ value of 0.64. Intraobserver rates were evaluated at a mean κ value of 0.69. The computer algorithm was successful in identifying the lumbar curve type and was in agreement with the observers by a proportion up to 93%. CONCLUSIONS: Agreement between and within observers for the Lenke lumbar modifier is only moderate to substantial with manual methods. Computer assistance with 3-dimensional models of the spine has the potential to decrease this variability. © 2009 Lippincott Williams & Wilkins, Inc.en_HK
dc.languageengen_HK
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.jspinaldisorders-tech.comen_HK
dc.relation.ispartofJournal of Spinal Disorders and Techniquesen_HK
dc.subjectCurve classificationen_HK
dc.subjectIdiopathic scoliosisen_HK
dc.subjectObserver variationen_HK
dc.subject.meshAlgorithms-
dc.subject.meshComputer Simulation-
dc.subject.meshImage Processing, Computer-Assisted - methods-
dc.subject.meshRadiology - methods-
dc.subject.meshScoliosis - classification - radiography-
dc.titleInterobserver and intraobserver variability in the identification of the lenke classification lumbar modifier in adolescent idiopathic scoliosisen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1536-0652&volume=22&issue=6&spage=448&epage=455&date=2009&atitle=Interobserver+and+intraobserver+variability+in+the+identification+of+the+Lenke+classification+lumbar+modifier+in+adolescent+idiopathic+scoliosis-
dc.identifier.emailCheung, KMC:cheungmc@hku.hken_HK
dc.identifier.authorityCheung, KMC=rp00387en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1097/BSD.0b013e3181831ef7en_HK
dc.identifier.pmid19652574-
dc.identifier.scopuseid_2-s2.0-68849100352en_HK
dc.identifier.hkuros180121en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-68849100352&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume22en_HK
dc.identifier.issue6en_HK
dc.identifier.spage448en_HK
dc.identifier.epage455en_HK
dc.identifier.isiWOS:000279665300013-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridDuong, L=7006651505en_HK
dc.identifier.scopusauthoridCheriet, F=6602858148en_HK
dc.identifier.scopusauthoridLabelle, H=7005665515en_HK
dc.identifier.scopusauthoridCheung, KMC=7402406754en_HK
dc.identifier.scopusauthoridAbel, MF=7102113609en_HK
dc.identifier.scopusauthoridNewton, PO=35402405100en_HK
dc.identifier.scopusauthoridMcCall, RE=7103137094en_HK
dc.identifier.scopusauthoridLenke, LG=7102707092en_HK
dc.identifier.scopusauthoridStokes, IAF=35592886300en_HK

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