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Inter- and Intraobserver Reliability of Pelvic Obliquity Measurement Methods in Patients With Cerebral Palsy

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Abstract

Study Design

Retrospective, chart review.

Objectives

The identification and management of pelvic obliquity in neuromuscular scoliosis can be difficult; therefore, appropriate evaluation of this pathology is important. Variations in presentation have resulted in various methods of measurement, without a consensus or gold standard measurement. This study is the evaluation of reliability of five methods commonly used to determine pelvic obliquity in the frontal plane.

Summary of Background Data

Previous studies have used five different methods (ie, the Maloney method, the O’Brien method, the Osebold method, the Allen and Ferguson method, and the Lindseth method) to determine pelvic obliquity in the frontal plane.

Methods

Radiographic images of 50 patients with neuromuscular scoliosis involving the pelvic girdle were identified and evaluated by a team of 5 raters. Each rater was instructed to apply five commonly used methods of measuring pelvic obliquity. The same raters were asked to rate the same radiographs again after a minimum of one month. The interobserver reliability was assessed using the intraclass correlation coefficient (ICC) and the intraobserver analysis was assessed using the Pearson correlation. A rating greater than 0.8 was considered excellent reliability.

Results

The Maloney method showing the highest interobserver reliability of ICC of 0.965 and 0.964. The Lindseth method had the lowest ICC, but all the methods were considered highly reliable by the rating classification system. The Maloney method also showed the highest intraobserver reliability, ranging from 0.845 to 0.962. The Allen and Ferguson method had the lowest intraobserver reliability.

Conclusions

Many of the methods tested had excellent reliability in this study, but our data suggest the Maloney method is the most reliable method of measuring pelvic obliquity on a frontal view radiograph.

Level of Evidence

Level III, retrospective, comparative study.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery and Rehabilitation, University of Mississippi Medical Center, 2500 North State Street, 39216, Jackson, MS, USA

    M. Wade Shrader MD

  2. Center for Pediatric Orthopaedics, Phoenix Children’s Hospital, 1919 East Thomas Road, 85006, Phoenix, AZ, USA

    Emily M. Andrisevic MD, Mohan V. Belthur MD, Gregory R. White MD & Carla Boan BA

  3. Orthopaedic Residency Program, Banner-University Medical Center, 1111 E McDowell Rd, 85006, Phoenix, AZ, USA

    William Wood MD

Authors
  1. M. Wade Shrader MD
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  2. Emily M. Andrisevic MD
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  3. Mohan V. Belthur MD
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  4. Gregory R. White MD
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  5. Carla Boan BA
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  6. William Wood MD
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Corresponding author

Correspondence to M. Wade Shrader MD.

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Author disclosures: none.

Financial Disclosure: No financial support was provided for this study.

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Shrader, M.W., Andrisevic, E.M., Belthur, M.V. et al. Inter- and Intraobserver Reliability of Pelvic Obliquity Measurement Methods in Patients With Cerebral Palsy. Spine Deform 6, 257–262 (2018). https://doi.org/10.1016/j.jspd.2017.10.001

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  • DOI: https://doi.org/10.1016/j.jspd.2017.10.001

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