Institute for Spinal Health and Performance, 460 Brannon Road, #101, Cumming, GA 30041, USA.
Curr Med Imaging. 2023;19(9):1071-1078. doi: 10.2174/1573405619666230206155900.
Spinal radiographic analyses are valid and reliable practices used for patient management in healthcare. Technologies and tools used for these analyses need to be valid and reliable.
This study investigates repeated accuracy for validity and intra- and inter-examiner reliability of computer-aided lateral spinal radiograph measurements using PostureRay EMR software.
Rectangle renderings representing lateral spinal radiographic views were created to remove examiner interpretation of anatomical landmarks as performed on actual radiographs to examine the objective repeated accuracy of PostureRay software. A blind, randomized, repeated measure design was performed using four examiners trained and experienced with the Harrison Posterior Tangent method of measurement. Each examiner analyzed the spine renderings using a hand-drawn and PostureRay method multiple times. A fully crossed design whereby examiners performed multiple assessments per rendering using each analysis method was used to assess intra- and inter-examiner reliability within each method and a formal comparison of the two methods.
Using hand-drawn and PostureRay methods, examiners displayed very high intra-examiner reliability with correlation values greater than 0.999 for each combination of trials. PostureRay method showed consistent accuracy of measurements. Further, there was no statistical difference in average concordance between hand-drawn and PostureRay methods for the lateral cervical, thoracic, and thoracolumbosacral spinal regions.
This study reports a very high degree of intra- and inter-examiner reliability of radiographic line drawing methods and establishes concurrent validity of PostureRay EMR software in determining angles and displacements of lateral spinal alignment as an equivalent method to the handdrawn method.
脊柱影像学分析是医疗保健中用于患者管理的有效且可靠的实践。用于这些分析的技术和工具需要是有效的和可靠的。
本研究旨在调查使用 PostureRay EMR 软件进行计算机辅助侧位脊柱 X 光测量的有效性和重复性以及观察者内和观察者间可靠性。
创建代表侧位脊柱 X 光视图的矩形渲染图，以消除观察者对实际 X 光片上解剖标志的解释，从而检查 PostureRay 软件的客观重复准确性。使用经过 Harrison 后切线测量法培训和经验丰富的四名观察者进行盲法、随机、重复测量设计。每位观察者使用手绘和 PostureRay 方法多次分析脊柱渲染图。使用完全交叉设计，每位观察者使用每种分析方法对每个渲染图进行多次评估，以评估每种方法内的观察者内和观察者间可靠性，并对两种方法进行正式比较。
使用手绘和 PostureRay 方法，每位观察者的观察者内可靠性非常高，每次试验的相关系数均大于 0.999。PostureRay 方法显示出测量的一致性准确性。此外，在手绘和 PostureRay 方法之间，对于颈椎、胸椎和胸腰椎骶骨侧位脊柱区域，平均一致性没有统计学差异。
本研究报告了射线绘图方法的观察者内和观察者间可靠性非常高，并确立了 PostureRay EMR 软件在确定侧位脊柱排列的角度和位移方面的同时有效性，作为与手绘方法等效的方法。
