Intraobserver and Interobserver Measurement Variability of the Rib-Vertebral Angle Difference

Robert G. Tysklind, Karen Myung, George Gantsoudes, Shyam Kishan, Chad Turner, Stella Lee, Matthew Wanner, Meagan Sabatino, Scott Linger, Randall Loder

Research output: Contribution to journalArticle

Abstract

BACKGROUND:: The rib-vertebral angle (RVAD) differentiates between progressive and resolving infantile idiopathic scoliosis (IIS) curves. Those with a RVAD<20 degrees often resolve without treatment, whereas those >20 degrees often progress and require treatment. The mathematical magnitude of RVAD measurement variability has not been described, and was thus the purpose of this study. It is important to know the reliability of RVAD measurements so as to understand changes that can be attributed to observer error alone. PURPOSE:: The purpose of the study was to mathematically determine the intraobserver and interobserver measurement variability of the RVAD difference in IIS. METHODS:: A convenience sample of 50 patients with IIS was selected. The RVAD was measured twice by 7 different observers separated by a minimum of 3 weeks. The 7 different readers chosen to measure the RVAD were 2 orthopaedic residents, 1 pediatric radiologist, and 4 attending pediatric orthopaedic surgeons. The same goniometer was used for all measurements. Intraobserver and interobserver measurement variability was determined using 3 well known used statistical methods. RESULTS:: The 3 different methods used to determine intraobserver and interobserver variability using 95% prediction/confidence limits gave very similar results. Intraobserver variability was ∼24 degrees and the interobserver variability was ∼23 degrees. DISCUSSION:: The utility of the RVAD in medical decision-making and counseling of patients with IIS should be approached with caution when used in isolation due to the large measurement variability. LEVEL OF EVIDENCE:: Level 3.

Original languageEnglish (US)
JournalJournal of Pediatric Orthopaedics
DOIs
StateAccepted/In press - Dec 14 2016

Fingerprint

Observer Variation
Ribs
Scoliosis
Pediatrics
Orthopedics
Counseling

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Orthopedics and Sports Medicine

Cite this

Intraobserver and Interobserver Measurement Variability of the Rib-Vertebral Angle Difference. / Tysklind, Robert G.; Myung, Karen; Gantsoudes, George; Kishan, Shyam; Turner, Chad; Lee, Stella; Wanner, Matthew; Sabatino, Meagan; Linger, Scott; Loder, Randall.

In: Journal of Pediatric Orthopaedics, 14.12.2016.

Research output: Contribution to journalArticle

Tysklind, Robert G. ; Myung, Karen ; Gantsoudes, George ; Kishan, Shyam ; Turner, Chad ; Lee, Stella ; Wanner, Matthew ; Sabatino, Meagan ; Linger, Scott ; Loder, Randall. / Intraobserver and Interobserver Measurement Variability of the Rib-Vertebral Angle Difference. In: Journal of Pediatric Orthopaedics. 2016.
@article{beee9cd073e9444fb178c96bc4bdca9e,
title = "Intraobserver and Interobserver Measurement Variability of the Rib-Vertebral Angle Difference",
abstract = "BACKGROUND:: The rib-vertebral angle (RVAD) differentiates between progressive and resolving infantile idiopathic scoliosis (IIS) curves. Those with a RVAD<20 degrees often resolve without treatment, whereas those >20 degrees often progress and require treatment. The mathematical magnitude of RVAD measurement variability has not been described, and was thus the purpose of this study. It is important to know the reliability of RVAD measurements so as to understand changes that can be attributed to observer error alone. PURPOSE:: The purpose of the study was to mathematically determine the intraobserver and interobserver measurement variability of the RVAD difference in IIS. METHODS:: A convenience sample of 50 patients with IIS was selected. The RVAD was measured twice by 7 different observers separated by a minimum of 3 weeks. The 7 different readers chosen to measure the RVAD were 2 orthopaedic residents, 1 pediatric radiologist, and 4 attending pediatric orthopaedic surgeons. The same goniometer was used for all measurements. Intraobserver and interobserver measurement variability was determined using 3 well known used statistical methods. RESULTS:: The 3 different methods used to determine intraobserver and interobserver variability using 95{\%} prediction/confidence limits gave very similar results. Intraobserver variability was ∼24 degrees and the interobserver variability was ∼23 degrees. DISCUSSION:: The utility of the RVAD in medical decision-making and counseling of patients with IIS should be approached with caution when used in isolation due to the large measurement variability. LEVEL OF EVIDENCE:: Level 3.",
author = "Tysklind, {Robert G.} and Karen Myung and George Gantsoudes and Shyam Kishan and Chad Turner and Stella Lee and Matthew Wanner and Meagan Sabatino and Scott Linger and Randall Loder",
year = "2016",
month = "12",
day = "14",
doi = "10.1097/BPO.0000000000000907",
language = "English (US)",
journal = "Journal of Pediatric Orthopaedics",
issn = "0271-6798",
publisher = "Lippincott Williams and Wilkins",

}

TY - JOUR

T1 - Intraobserver and Interobserver Measurement Variability of the Rib-Vertebral Angle Difference

AU - Tysklind, Robert G.

AU - Myung, Karen

AU - Gantsoudes, George

AU - Kishan, Shyam

AU - Turner, Chad

AU - Lee, Stella

AU - Wanner, Matthew

AU - Sabatino, Meagan

AU - Linger, Scott

AU - Loder, Randall

PY - 2016/12/14

Y1 - 2016/12/14

N2 - BACKGROUND:: The rib-vertebral angle (RVAD) differentiates between progressive and resolving infantile idiopathic scoliosis (IIS) curves. Those with a RVAD<20 degrees often resolve without treatment, whereas those >20 degrees often progress and require treatment. The mathematical magnitude of RVAD measurement variability has not been described, and was thus the purpose of this study. It is important to know the reliability of RVAD measurements so as to understand changes that can be attributed to observer error alone. PURPOSE:: The purpose of the study was to mathematically determine the intraobserver and interobserver measurement variability of the RVAD difference in IIS. METHODS:: A convenience sample of 50 patients with IIS was selected. The RVAD was measured twice by 7 different observers separated by a minimum of 3 weeks. The 7 different readers chosen to measure the RVAD were 2 orthopaedic residents, 1 pediatric radiologist, and 4 attending pediatric orthopaedic surgeons. The same goniometer was used for all measurements. Intraobserver and interobserver measurement variability was determined using 3 well known used statistical methods. RESULTS:: The 3 different methods used to determine intraobserver and interobserver variability using 95% prediction/confidence limits gave very similar results. Intraobserver variability was ∼24 degrees and the interobserver variability was ∼23 degrees. DISCUSSION:: The utility of the RVAD in medical decision-making and counseling of patients with IIS should be approached with caution when used in isolation due to the large measurement variability. LEVEL OF EVIDENCE:: Level 3.

AB - BACKGROUND:: The rib-vertebral angle (RVAD) differentiates between progressive and resolving infantile idiopathic scoliosis (IIS) curves. Those with a RVAD<20 degrees often resolve without treatment, whereas those >20 degrees often progress and require treatment. The mathematical magnitude of RVAD measurement variability has not been described, and was thus the purpose of this study. It is important to know the reliability of RVAD measurements so as to understand changes that can be attributed to observer error alone. PURPOSE:: The purpose of the study was to mathematically determine the intraobserver and interobserver measurement variability of the RVAD difference in IIS. METHODS:: A convenience sample of 50 patients with IIS was selected. The RVAD was measured twice by 7 different observers separated by a minimum of 3 weeks. The 7 different readers chosen to measure the RVAD were 2 orthopaedic residents, 1 pediatric radiologist, and 4 attending pediatric orthopaedic surgeons. The same goniometer was used for all measurements. Intraobserver and interobserver measurement variability was determined using 3 well known used statistical methods. RESULTS:: The 3 different methods used to determine intraobserver and interobserver variability using 95% prediction/confidence limits gave very similar results. Intraobserver variability was ∼24 degrees and the interobserver variability was ∼23 degrees. DISCUSSION:: The utility of the RVAD in medical decision-making and counseling of patients with IIS should be approached with caution when used in isolation due to the large measurement variability. LEVEL OF EVIDENCE:: Level 3.

UR - http://www.scopus.com/inward/record.url?scp=85006275587&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85006275587&partnerID=8YFLogxK

U2 - 10.1097/BPO.0000000000000907

DO - 10.1097/BPO.0000000000000907

M3 - Article

C2 - 27984489

AN - SCOPUS:85006275587

JO - Journal of Pediatric Orthopaedics

JF - Journal of Pediatric Orthopaedics

SN - 0271-6798

ER -