• Spine · Dec 2013

    Comprehensive vertebral deformity and vertebral fracture assessment in clinical practice: intra- and inter-reader agreement of a clinical workflow tool.

    • Giuseppe Guglielmi, Jane Haslam, Francesco DʼErrico, Peter Steiger, and Michelangelo Nasuto.
    • *Department of Radiology, University of Foggia, Viale Luigi Pinto, Foggia, Italy †Department of Radiology, Scientific Institute Hospital "Casa Sollievo della Sofferenza," Viale Cappuccini, San Giovanni Rotondo, Foggia, Italy ‡Optasia Medical Ltd, Mellor House, Cheadle Hulme, Cheadle, United Kingdom; and §Optasia Medical Inc, Sudbury, MA.
    • Spine. 2013 Dec 15;38(26):E1676-83.

    Study DesignStudy design randomized intra- and inter-reader reproducibility study.ObjectiveTo evaluate reproducibility of quantitative morphometry (QM) and agreement of dichotomous fracture/no-fracture status on lateral spinal radiographs acquired during routine clinical practice using a clinical workflow tool.Summary Of Background DataSeveral recent guidelines have underlined the importance of Genant semi-quantitative scoring and selective QM to confirm and grade suspected vertebral fractures in clinical practice.MethodsThoracic and lumbar spine radiographs were acquired from 98 consecutive subjects (mean age, 60.1 ± 11.7 yr) attending the clinic for osteoporosis evaluation. For each subject, QM and Genant semi-quantitative scoring were performed on all evaluable vertebrae from L4 to T4 using a software workflow tool. A radiologist and an experienced radiographical technician performed 2 repeat reading sessions of the radiographs 12 months apart, blinded to each other's results; for the second read, the cases were anonymized and the order was randomized.ResultsInter-reader reproducibility results were 3.1% and 3.2% coefficient of variation (%) for heights, 0.030 and 0.031 root mean square standard deviation for height ratios. For intrareader reproducibility, these values were 2.2% and 3.5% coefficient of variation %; 0.023 and 0.034 root mean square standard deviation. Kappa score results for agreement of dichotomous fracture/no-fracture status were 0.67 and 0.72 (inter-rater) and 0.50 and 0.67 (intrarater).ConclusionThe software assessed in this study is a reliable clinical tool that facilitates QM and Genant semi-quantitative scoring of the spine in routine clinical practice.Level Of Evidence3.

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