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Reliability and construct validity of the compatible MRI scoring system for evaluation of elbows in haemophilic children.

Doria, A S; Lundin, Björn LU ; Miller, S; Kilcoyne, R; Dunn, A; Thomas, S; Rivard, G; Moineddin, R; Babyn, P S and Expert Imaging Working Group of the International Prophylaxis Study Group, and (2008) In Haemophilia 14(2). p.303-314
Abstract
Summary. We assessed the reliability and construct validity of the Compatible MRI scale for evaluation of elbows, and compared the diagnostic performance of MRI and radiographs for assessment of these joints. Twenty-nine MR examinations of elbows from 27 boys with haemophilia A and B [age range, 5–17 years (mean, 11.5)] were independently read by four blinded radiologists on two occasions. Three centres participated in the study: (Toronto, n = 24 examinations; Atlanta, n = 3; Cuiaba, n = 2). The number of previous joint bleeds and severity of haemophilia were reference standard measures. The inter-reader reliability of MRI scores was substantial (ICC = 0.73) for the additive (A)-scale and excellent (ICC = 0.83) for the progressive... (More)
Summary. We assessed the reliability and construct validity of the Compatible MRI scale for evaluation of elbows, and compared the diagnostic performance of MRI and radiographs for assessment of these joints. Twenty-nine MR examinations of elbows from 27 boys with haemophilia A and B [age range, 5–17 years (mean, 11.5)] were independently read by four blinded radiologists on two occasions. Three centres participated in the study: (Toronto, n = 24 examinations; Atlanta, n = 3; Cuiaba, n = 2). The number of previous joint bleeds and severity of haemophilia were reference standard measures. The inter-reader reliability of MRI scores was substantial (ICC = 0.73) for the additive (A)-scale and excellent (ICC = 0.83) for the progressive (P)-scale. The intrareader reliability was excellent for both P-scores (ICC = 0.91) and A-scores (ICC = 0.93). The total P- and A-scores correlated poorly (r = 0.36) or moderately (r = 0.54), but positively, with clinical-laboratory measurements. The total MRI scores demonstrated high accuracy for discrimination of presence or absence of arthropathy [P-scale, area-under-the-curve (AUC) = 0.94 ± 0.05; A-scale, AUC = 0.89 ± 0.06], as did the soft tissue scores of both scales (P-scale, AUC = 0.90 ± 0.06; A-scale, AUC = 0.86 ± 0.06). Areas-under-the-curve used to discriminate severe disease demonstrated high accuracy for both P-MRI scores (AUC = 0.83 ± 0.09) and A-MRI scores (AUC = 0.87 ± 0.09), but non-diagnostic ability to discriminate mild disease. Similar results were noted for radiographic scales. In conclusion, both MRI scales demonstrated substantial to excellent reliability and accuracy for discrimination of presence/absence of arthropathy, and severe/non-severe disease, but poor to moderate convergent validity for total scores and non-diagnostic discriminant validity for mild/non-mild disease. Compared with radiographic scores, MRI scales did not perform better for discrimination of severity of arthropathy. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
validity, scoring systems, reliability, progressive, magnetic resonance imaging, haemophilia, children, arthropathy, additive
in
Haemophilia
volume
14
issue
2
pages
303 - 314
publisher
Federation of European Neuroscience Societies and Blackwell Publishing Ltd
external identifiers
  • WOS:000253626100011
  • Scopus:40349100415
ISSN
1351-8216
DOI
10.1111/j.1365-2516.2007.01602.x
language
English
LU publication?
yes
id
8533420a-a130-4483-b35a-ab9bf07c2e59 (old id 1144752)
date added to LUP
2008-08-15 08:45:30
date last changed
2016-12-04 04:45:42
@misc{8533420a-a130-4483-b35a-ab9bf07c2e59,
  abstract     = {Summary. We assessed the reliability and construct validity of the Compatible MRI scale for evaluation of elbows, and compared the diagnostic performance of MRI and radiographs for assessment of these joints. Twenty-nine MR examinations of elbows from 27 boys with haemophilia A and B [age range, 5–17 years (mean, 11.5)] were independently read by four blinded radiologists on two occasions. Three centres participated in the study: (Toronto, n = 24 examinations; Atlanta, n = 3; Cuiaba, n = 2). The number of previous joint bleeds and severity of haemophilia were reference standard measures. The inter-reader reliability of MRI scores was substantial (ICC = 0.73) for the additive (A)-scale and excellent (ICC = 0.83) for the progressive (P)-scale. The intrareader reliability was excellent for both P-scores (ICC = 0.91) and A-scores (ICC = 0.93). The total P- and A-scores correlated poorly (r = 0.36) or moderately (r = 0.54), but positively, with clinical-laboratory measurements. The total MRI scores demonstrated high accuracy for discrimination of presence or absence of arthropathy [P-scale, area-under-the-curve (AUC) = 0.94 ± 0.05; A-scale, AUC = 0.89 ± 0.06], as did the soft tissue scores of both scales (P-scale, AUC = 0.90 ± 0.06; A-scale, AUC = 0.86 ± 0.06). Areas-under-the-curve used to discriminate severe disease demonstrated high accuracy for both P-MRI scores (AUC = 0.83 ± 0.09) and A-MRI scores (AUC = 0.87 ± 0.09), but non-diagnostic ability to discriminate mild disease. Similar results were noted for radiographic scales. In conclusion, both MRI scales demonstrated substantial to excellent reliability and accuracy for discrimination of presence/absence of arthropathy, and severe/non-severe disease, but poor to moderate convergent validity for total scores and non-diagnostic discriminant validity for mild/non-mild disease. Compared with radiographic scores, MRI scales did not perform better for discrimination of severity of arthropathy.},
  author       = {Doria, A S and Lundin, Björn and Miller, S and Kilcoyne, R and Dunn, A and Thomas, S and Rivard, G and Moineddin, R and Babyn, P S and Expert Imaging Working Group of the International Prophylaxis Study Group, and},
  issn         = {1351-8216},
  keyword      = {validity,scoring systems,reliability,progressive,magnetic resonance imaging,haemophilia,children,arthropathy,additive},
  language     = {eng},
  number       = {2},
  pages        = {303--314},
  publisher    = {ARRAY(0x9f64110)},
  series       = {Haemophilia},
  title        = {Reliability and construct validity of the compatible MRI scoring system for evaluation of elbows in haemophilic children.},
  url          = {http://dx.doi.org/10.1111/j.1365-2516.2007.01602.x},
  volume       = {14},
  year         = {2008},
}