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Observer variation for radiography, computed tomography, and magnetic resonance imaging of occult hip fractures

Collin, David; Dunker, Dennis; Gothlin, Jan H. and Geijer, Mats LU (2011) In Acta Radiologica 52(8). p.871-874
Abstract
Background: Conventional radiography is insufficient for diagnosis in a small but not unimportant number of hip fractures, and secondary imaging with computed tomography (CT) or magnetic resonance imaging (MRI) is warranted. There are no convincing observer variation studies performed for conventional radiography or CT in occult fractures, and no large materials for MRI. Purpose: To assess observer variation in radiography, CT and MRI of suspected occult, non-displaced hip fractures, and to evaluate to what extent observer experience or patient age may influence observer performance. Material and Methods: A total of 375 patients after hip trauma where radiography was followed by CT or MRI to evaluate a suspected occult hip fracture were... (More)
Background: Conventional radiography is insufficient for diagnosis in a small but not unimportant number of hip fractures, and secondary imaging with computed tomography (CT) or magnetic resonance imaging (MRI) is warranted. There are no convincing observer variation studies performed for conventional radiography or CT in occult fractures, and no large materials for MRI. Purpose: To assess observer variation in radiography, CT and MRI of suspected occult, non-displaced hip fractures, and to evaluate to what extent observer experience or patient age may influence observer performance. Material and Methods: A total of 375 patients after hip trauma where radiography was followed by CT or MRI to evaluate a suspected occult hip fracture were collected retrospectively from two imaging centers. After scoring by three observers with varying degrees of radiologic experience, observer variation was assessed by using linear weighted kappa statistics. Results: For radiography, agreements between the three observers were moderate to substantial for intracapsular fractures, with kappa values in the ranges of 0.56-0.66. Kappa values were substantial for extracapsular fractures, in the ranges of 0.69-0.72. With increasing professional experience, fewer fractures were classified as equivocal at radiography. For CT and MRI, observer agreements were similar and almost perfect, with kappa values in the ranges of 0.85-0.97 and 0.93-0.97. Conclusion: There were almost perfect observer agreements for CT and MRI in diagnosing non-displaced, occult hip fractures. Observer agreements for radiography were moderate to substantial, and observer experience influenced agreement only at radiography. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Hip fracture diagnosis, observer variation, radiography, computed, tomography, magnetic resonance imaging, quality assurance
in
Acta Radiologica
volume
52
issue
8
pages
871 - 874
publisher
John Wiley & Sons
external identifiers
  • wos:000296488400010
  • scopus:83155164700
ISSN
1600-0455
DOI
10.1258/ar.2011.110032
language
English
LU publication?
yes
id
4e359316-581f-4767-b551-309df218b319 (old id 2208093)
date added to LUP
2011-11-30 09:14:13
date last changed
2017-01-01 06:14:25
@article{4e359316-581f-4767-b551-309df218b319,
  abstract     = {Background: Conventional radiography is insufficient for diagnosis in a small but not unimportant number of hip fractures, and secondary imaging with computed tomography (CT) or magnetic resonance imaging (MRI) is warranted. There are no convincing observer variation studies performed for conventional radiography or CT in occult fractures, and no large materials for MRI. Purpose: To assess observer variation in radiography, CT and MRI of suspected occult, non-displaced hip fractures, and to evaluate to what extent observer experience or patient age may influence observer performance. Material and Methods: A total of 375 patients after hip trauma where radiography was followed by CT or MRI to evaluate a suspected occult hip fracture were collected retrospectively from two imaging centers. After scoring by three observers with varying degrees of radiologic experience, observer variation was assessed by using linear weighted kappa statistics. Results: For radiography, agreements between the three observers were moderate to substantial for intracapsular fractures, with kappa values in the ranges of 0.56-0.66. Kappa values were substantial for extracapsular fractures, in the ranges of 0.69-0.72. With increasing professional experience, fewer fractures were classified as equivocal at radiography. For CT and MRI, observer agreements were similar and almost perfect, with kappa values in the ranges of 0.85-0.97 and 0.93-0.97. Conclusion: There were almost perfect observer agreements for CT and MRI in diagnosing non-displaced, occult hip fractures. Observer agreements for radiography were moderate to substantial, and observer experience influenced agreement only at radiography.},
  author       = {Collin, David and Dunker, Dennis and Gothlin, Jan H. and Geijer, Mats},
  issn         = {1600-0455},
  keyword      = {Hip fracture diagnosis,observer variation,radiography,computed,tomography,magnetic resonance imaging,quality assurance},
  language     = {eng},
  number       = {8},
  pages        = {871--874},
  publisher    = {John Wiley & Sons},
  series       = {Acta Radiologica},
  title        = {Observer variation for radiography, computed tomography, and magnetic resonance imaging of occult hip fractures},
  url          = {http://dx.doi.org/10.1258/ar.2011.110032},
  volume       = {52},
  year         = {2011},
}