智能手机数字照片测量拇外翻角的有效性和可靠性。

Validity and reliability of hallux valgus angle measurement on smartphone digital photographs.

机构信息

Istanbul Training and Research Hospital, Department of Orthopedics and Traumatology, Istanbul, Turkey.

Antalya Training and Research Hospital, Department of Orthopedics and Traumatology, Varlık mah, Kazım Karabekir cd Address Muratpasa, Antalya, 07100, Turkey.

出版信息

J Foot Ankle Res. 2023 Oct 16;16(1):70. doi: 10.1186/s13047-023-00670-8.

DOI:10.1186/s13047-023-00670-8

PMID:37840128

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10577965/

Abstract

BACKGROUND

This prospective study aimed to test the reliability and validity of hallux valgus angle (HVA) measurement on smartphone digital photographs compared with the standard radiographic evaluation.

METHODS

Twenty Seven female patients (45 feet) with forefoot deformity were evaluated with weight-bearing anteroposterior foot radiographs and smartphone photographs. Radiographic hallux valgus angle (rHVA) was measured on digital radiographs. Two different photographic HVA measurement methods were used. In the first, the longitudinal axes of the first metatarsal and proximal phalanx were determined, and the angle between these axes was measured (pHVA), similar to the radiographic method. In the other method, the angle of the margo medialis pedis was measured on the photograph (pMMP). Two independent observers performed all measurements twice on two different occasions. Reliability analysis was performed using the interclass correlation coefficient. Agreement between the measurements was tested using Bland-Altman analysis.

RESULTS

The repeated rHVA, pHVA and pMMP measurements showed excellent intra and inter-observer reliability, with ICC values above 0.900. The mean rHVA, pHVA, and pMMP were statistically similar (p:0.929, 27.03°±8.7°, 27.11°±8.8° and 26.5°±9.0° respectively). The mean difference between the rHVA and pHVA was - 0.07°±5.1° (range, --9.67 to 9.56°), and the mean difference between the rHVA and pMMP was 0.53°±4.4° (range, -9.76° to 8.22°). There was a strong positive correlation between both photographic methods and radiographic measurements (rho = 0.809, p = 0.001 and rho = 0.872, p = 0.001). In the Bland Altman plot, the upper and lower LOAs (95%CI) ranged from - 10.11° to 9.93° for rHVA and pHVA, and from - 8.26° to 9.33° for rHVA and pMMP. Linear regression analysis showed a proportional bias for pHVA but not for the pMMP (p:0.010 versus p:0.633, respectively). The range of the mean difference (prediction interval) between the pMMP and rHVA was 17.59° and 20° for pHVA and rHVA. Simple linear regression showed that the rHVA was predicted by the following equation: rHVA = 4.73 + 0.84 × pMMP (r2 = 0.761, p < 0.001).

CONCLUSIONS

Although measuring HVA through smartphone photographs is reliable, it is not a valid prediction method.

LEVEL OF EVIDENCE

Level II, diagnostic assessment.

摘要

背景

本前瞻性研究旨在测试智能手机数字照片测量拇外翻角（HVA）与标准放射评估相比的可靠性和有效性。

方法

27 名（45 足）前足畸形的女性患者接受负重前后足 X 线片和智能手机照片检查。在数字射线照片上测量放射学拇外翻角（rHVA）。使用两种不同的摄影 HVA 测量方法。在第一种方法中，确定第一跖骨和近节趾骨的纵轴，并测量这些轴之间的角度（pHVA），类似于放射学方法。在另一种方法中，在照片上测量内侧跖骨边缘角（pMMP）。两名独立观察者在两个不同的场合进行了两次所有测量。使用组内相关系数进行可靠性分析。使用 Bland-Altman 分析测试测量值之间的一致性。

结果

rHVA、pHVA 和 pMMP 的重复测量具有极好的内部和观察者间可靠性，ICC 值均高于 0.900。rHVA、pHVA 和 pMMP 的平均值在统计学上相似（p：0.929，27.03°±8.7°，27.11°±8.8°和 26.5°±9.0°）。rHVA 与 pHVA 之间的平均差异为-0.07°±5.1°（范围为-9.67°至 9.56°），rHVA 与 pMMP 之间的平均差异为 0.53°±4.4°（范围为-9.76°至 8.22°）。两种摄影方法与放射学测量值之间存在很强的正相关（rho=0.809，p=0.001 和 rho=0.872，p=0.001）。在 Bland-Altman 图中，rHVA 和 pHVA 的上下 LOA（95%CI）范围为-10.11°至 9.93°，rHVA 和 pMMP 的 LOA 范围为-8.26°至 9.33°。线性回归分析显示 pHVA 存在比例偏差，但 pMMP 没有（p：0.010 与 p：0.633）。pMMP 和 rHVA 之间平均差值（预测区间）的范围为 17.59°和 20°，用于 pHVA 和 rHVA。简单线性回归表明，rHVA 由以下方程预测：rHVA=4.73+0.84×pMMP（r2=0.761，p<0.001）。