Wessely Marlis, Brühschwein Andreas, Schnabl-Feichter Eva
Department for Companion Animals and Horses, University Clinic for Small Animals, Small Animal Surgery, University of Veterinary Medicine, Vienna, Austria.
Clinic of Small Animal Surgery and Reproduction, Centre of Clinical Veterinary Medicine, Ludwig-Maximilians-University Munich, Munich, Germany.
Vet Comp Orthop Traumatol. 2017 Nov;30(6):377-384. doi: 10.3415/VCOT-16-09-0134. Epub 2017 Dec 4.
To evaluate the intra- and inter-observer measurement variability of an existing osteoarthritis (OA) stifle scoring system. Paired caudocranial and mediolateral canine stifle radiographs were selected randomly. A total of 15 assessment points were evaluated independently and graded twice (integer numeric scale: 1-4) at an interval of 2 weeks by three observers with different levels of experience. The grades for each of the 15 factors were summed to obtain the OA score for each patient. The 15 independent assessment points measured by the three observers showed high reproducibility and low intra-observer variability. Inter-observer variability was also low (mean: 1.09 ± 4.99, 95% CI [confidence interval]: -0.35 to 2.55). The most discordant ratings among the three observers involved sesamoid bones of gastrocnemius muscle (assessment point 11 of 15) and popliteal surface of femur (assessment point 10 of 15). A validated and feasible OA scoring method is prerequisite for reliable radiographic assessment of OA progression. The low overall inter- and intra-observer variabilities among the 15 independent measures of the OA scoring system presented herein support its feasibility for application in clinical practice as an objective tool for radiographic scoring of stifle OA.
评估现有骨关节炎(OA) stifle评分系统在观察者内和观察者间的测量变异性。随机选择成对的犬尾颅侧和内外侧 stifle X光片。由三名经验水平不同的观察者对总共15个评估点进行独立评估,并每隔2周进行两次评分(整数数值量表:1 - 4)。将15个因素中的每个因素的评分相加,得出每位患者的OA评分。三名观察者测量的15个独立评估点显示出高重复性和低观察者内变异性。观察者间变异性也很低(均值:1.09±4.99,95%置信区间[CI]:-0.35至2.55)。三名观察者之间最不一致的评分涉及腓肠肌籽骨(15个评估点中的第11点)和股骨腘面(15个评估点中的第10点)。经过验证且可行的OA评分方法是可靠的OA进展影像学评估的前提条件。本文介绍的OA评分系统的15项独立测量中,总体观察者间和观察者内变异性较低,支持其作为 stifle OA影像学评分的客观工具在临床实践中应用的可行性。
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