Schippers Philipp, Meurer Andrea, Schnetz Matthias, Ewald Larissa, Ruckes Christian, Hoffmann Reinhard, Gramlich Yves
Department of Orthopedic Surgery, University Medical Centre, Johannes Gutenberg University Mainz, 55131 Mainz, Germany.
Medical Park Kliniken Bad Wiessee, 83707 Bad Wiessee, Germany.
Life (Basel). 2023 Aug 24;13(9):1805. doi: 10.3390/life13091805.
Image analysis plays a central role in orthopedics and research but comes with many challenges, including anonymization, bias, and achieving efficient analyses using multiple independent observers. Appropriate software is still lacking. Tyche is a free online tool that displays images in a random order without showing any metadata. Additionally, when using Tyche, observers can store results in the same window, and the final results are immediately visible to the project manager. In this study, we compared results from Tyche with those from a validated tool. One hundred pelvic radiographs were analyzed separately by five orthopedic surgeons using both Tyche and the validated software. Common orthopedic measurement modalities and scores were determined. The methods were compared using intra-class correlations and Fleiss' kappa coefficients as well as Bland-Altman plots. Significant correlations ranging from r = 0.17 (Kallgren and Lawrence Score) to r = 0.99 (area measurements) were calculated for inter- and intraobserver agreements between the two tools for all measurements. The Bland-Altman plots indicated the non-inferiority of either tool. The images were analyzed significantly faster when Tyche was used. We conclude that Tyche is a valid tool for use in orthopedic image analysis. Tyche could be utilized for determining inter- and intraobserver agreements, in multicenter studies and for score validations.
图像分析在骨科及研究中发挥着核心作用，但也面临诸多挑战，包括去识别化、偏差以及利用多名独立观察者实现高效分析等。目前仍缺乏合适的软件。Tyche是一款免费在线工具，它以随机顺序显示图像且不显示任何元数据。此外，使用Tyche时，观察者可在同一窗口存储结果，项目经理能立即看到最终结果。在本研究中，我们将Tyche的结果与一款经过验证的工具的结果进行了比较。五名骨科外科医生分别使用Tyche和经过验证的软件对100张骨盆X光片进行分析。确定了常见的骨科测量方式和评分。使用组内相关系数、Fleiss卡方系数以及Bland-Altman图对两种方法进行比较。对于所有测量，两种工具之间观察者间和观察者内一致性的相关系数范围为r = 0.17（卡尔格伦和劳伦斯评分）至r = 0.99（面积测量）。Bland-Altman图表明两种工具均无劣势。使用Tyche时图像分析速度明显更快。我们得出结论，Tyche是用于骨科图像分析的有效工具。Tyche可用于多中心研究中确定观察者间和观察者内的一致性以及评分验证。
