TY - JOUR
T1 - Radiographic diagnosis of scapholunate dissociation among intra-articular fractures of the distal radius
T2 - Interobserver reliability
AU - Science of Variation Group
AU - Gradl, Gertraud
AU - Neuhaus, Valentin
AU - Fuchsberger, Thomas
AU - Guitton, Thierry G.
AU - Prommersberger, Karl Josef
AU - Ring, David
AU - Wahegaonkar, Abhijeet L.
AU - Shafritz, Adam B.
AU - Garcia, Aida E.
AU - Caputo, Andrew E.
AU - Terrono, Andrew L.
AU - Spoor, Andy B.
AU - Eschler, Anica
AU - Vochteloo, Anne J.H.
AU - Beumer, Annechien
AU - Barquet, Antonio
AU - Kristan, Anze
AU - Van Der Zwan, Arnard L.
AU - Berner, Arne
AU - Ilyas, Asif
AU - Jubel, Axel
AU - Sutker, Ben
AU - Nolan, Betsy M.
AU - Petrisor, Brad
AU - Cross, Brian J.
AU - Wills, Brian P.D.
AU - Barreto, Camilo J.R.
AU - Fernandes, Carlos H.
AU - Swigart, Carrie
AU - Zalavras, Charalampos
AU - Goldfarb, Charles A.
AU - Cassidy, Charles
AU - Eaton, Charles
AU - Wilson, Chris
AU - Cheng, Christine J.
AU - Wall, Christopher J.
AU - Walsh, Christopher J.
AU - Jones, Christopher M.
AU - Garnavos, Christos
AU - Young, Colby
AU - Klostermann, Cyrus
AU - Kirkpatrick, D. Kay
AU - Osei, Daniel A.
AU - Rikli, Daniel A.
AU - Wascher, Daniel C.
AU - Polatsch, Daniel
AU - Silva, Dario Mejia
AU - Nelson, David L.
AU - Kalainov, David M.
AU - Hauck, Randy
N1 - Publisher Copyright:
© 2013 by the American Society for Surgery of the Hand. All rights reserved.
PY - 2013/9
Y1 - 2013/9
N2 - Purpose: To evaluate the reliability and accuracy of diagnosis of scapholunate dissociation (SLD) among AO type C (compression articular) fractures of the distal radius. Methods: A total of 217 surgeons evaluated 21 sets of radiographs with type C fractures of the distal radius for which the status of the scapholunate interosseous ligament was established by preoperative 3-compartment computed tomographic arthrography with direct operative visualization of diagnosed SLD (reference standard). Observers were asked whether SLD was present, and if yes, whether they would recommend operative treatment. Diagnostic performance characteristics were calculated with respect to the reference standard. We assessed interobserver reliability using the Fleiss generalized kappa. Results: The interobserver agreement for radiographic diagnosis of SLD was moderate (κ = 0.44). Correct diagnosis for a given set of radiographs ranged from 8% to 98% (average, 79%) of observers. Diagnostic performance characteristics were: 69% sensitivity, 84% specificity, 84% accuracy, 68% positive predictive value, and 84% negative predictive value. Based on a prevalence of 5%, Bayes adjusted positive and negative predictive values were 18% and 98%, respectively. Raters recommended operative treatment in 74% to 100% of patients diagnosed with SLD. Conclusions: Radiographs are moderately reliable and are better at ruling out than ruling in SLD associated with type C fracture of the distal radius.
AB - Purpose: To evaluate the reliability and accuracy of diagnosis of scapholunate dissociation (SLD) among AO type C (compression articular) fractures of the distal radius. Methods: A total of 217 surgeons evaluated 21 sets of radiographs with type C fractures of the distal radius for which the status of the scapholunate interosseous ligament was established by preoperative 3-compartment computed tomographic arthrography with direct operative visualization of diagnosed SLD (reference standard). Observers were asked whether SLD was present, and if yes, whether they would recommend operative treatment. Diagnostic performance characteristics were calculated with respect to the reference standard. We assessed interobserver reliability using the Fleiss generalized kappa. Results: The interobserver agreement for radiographic diagnosis of SLD was moderate (κ = 0.44). Correct diagnosis for a given set of radiographs ranged from 8% to 98% (average, 79%) of observers. Diagnostic performance characteristics were: 69% sensitivity, 84% specificity, 84% accuracy, 68% positive predictive value, and 84% negative predictive value. Based on a prevalence of 5%, Bayes adjusted positive and negative predictive values were 18% and 98%, respectively. Raters recommended operative treatment in 74% to 100% of patients diagnosed with SLD. Conclusions: Radiographs are moderately reliable and are better at ruling out than ruling in SLD associated with type C fracture of the distal radius.
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U2 - 10.1016/j.jhsa.2013.05.039
DO - 10.1016/j.jhsa.2013.05.039
M3 - Article
C2 - 23910379
AN - SCOPUS:84883184855
SN - 0363-5023
VL - 38
SP - 1685
EP - 1690
JO - Journal of Hand Surgery
JF - Journal of Hand Surgery
IS - 9
ER -