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Intra- and Inter-rater Reliability of Coronal Curvature Measurement for Adolescent Idiopathic Scoliosis Using Ultrasonic Imaging Method—A Pilot Study

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Abstract

Study Design

Retrospective reliability study of the coronal curvature measurement on ultrasound (US) imaging in adolescent idiopathic scoliosis (AIS).

Objectives

To determine the intra- and inter-rater reliability and validity of the coronal curvature measurements obtained from US images.

Summary of Background Data

Cobb angle measurements on radiographs are the usual method to diagnose and monitor the progression of scoliosis. Repeated ionizing radiation exposure is a frequent concern of patients and their families. Use of US imaging method to measure coronal curvature in children who have idiopathic scoliosis has not been clinically validated.

Methods

The researchers scanned 26 subjects using a medical 3-dimensional US system. Spinal radiographs were obtained on the same day from the local scoliosis clinic. Three raters used the center of lamina method to measure the coronal curvature on the US images twice 1 week apart. The raters also measured the Cobb angle on the radiographs twice. Intra- and inter-rater reliability of the coronal curvature measurement from the US images was analyzed using intra-class correlation coefficients. The correlation coefficient of the US coronal curvature measurements was compared with the Cobb angles.

Results

The intra-class correlation coefficient (2,1) values of intra- and inter-rater reliability on the US method were greater than 0.80. Standard error of measurement on both of the intra- and inter-rater US methods was less than 2.8°. The correlation coefficient between the US and radiographic methods ranged between 0.78 and 0.84 among 3 raters.

Conclusions

The US method illustrated substantial intra- and inter-rater reliability. The measurement difference between radiography and the US method was within the range of clinically acceptable error (5°). The US method may be considered a radiation-free alternative to assess children with scoliosis of mild to moderate severity.

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Authors and Affiliations

  1. Department of Surgery, University of Alberta, 8440 - 112 Street, Edmonton, Canada, T6G 2B7

    Rui Zheng PhD, Amanda C. Y. Chan, Douglas L. Hill MBA, Douglas Hedden MD, Marc Moreau MD, James Mahood MD, Sarah Southon NP & Edmond Lou PhD

  2. Department of Biomedical Engineering, University of Alberta, 8308-114 Street, Edmonton, Canada, T6G 2V2

    Wei Chen PhD

  3. Glenrose Rehabilitation Hospital, Alberta Health Services, Glenrose Rehabilitation Research Centre, 10105 112 Avenue, Edmonton, Canada, T5G 0H1

    Douglas L. Hill MBA & Edmond Lou PhD

  4. Department of Radiology and Diagnostic Imaging, University of Alberta, 8440-112 Street, Edmonton, Canada, T6G 2B7

    Lawrence H. Le PhD

Authors
  1. Rui Zheng PhD
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  2. Amanda C. Y. Chan
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  3. Wei Chen PhD
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  4. Douglas L. Hill MBA
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  5. Lawrence H. Le PhD
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  6. Douglas Hedden MD
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  7. Marc Moreau MD
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  8. James Mahood MD
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  9. Sarah Southon NP
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  10. Edmond Lou PhD
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Corresponding author

Correspondence to Edmond Lou PhD.

Additional information

Author disclosures: RZ (none); ACYC (none); WC (none); DLH (none); LHL (none); DH (none); MM (none); JM (none); SS (none); EL (none).

This work was supported by the Women’s and Children’s Health Research Institute and the Edmonton Orthopaedic Research Society.

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Zheng, R., Chan, A.C.Y., Chen, W. et al. Intra- and Inter-rater Reliability of Coronal Curvature Measurement for Adolescent Idiopathic Scoliosis Using Ultrasonic Imaging Method—A Pilot Study. Spine Deform 3, 151–158 (2015). https://doi.org/10.1016/j.jspd.2014.08.008

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  • DOI: https://doi.org/10.1016/j.jspd.2014.08.008

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