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Equine veterinary journal2024; 57(2); 406-418; doi: 10.1111/evj.14126

Interobserver agreement during clinical magnetic resonance imaging of the equine foot.

Abstract: Agreement between experienced observers for assessment of pathology and assessment confidence are poorly documented for magnetic resonance imaging (MRI) of the equine foot. Objective: To report interobserver agreement for pathology assessment and observer confidence for key anatomical structures of the equine foot during MRI. Methods: Exploratory clinical study. Methods: Ten experienced observers (diploma or associate level) assessed 15 equine foot MRI studies acquired from clinical databases of 3 MRI systems. Observers graded pathology in seven key anatomical structures (Grade 1: no pathology, Grade 2: mild pathology, Grade 3: moderate pathology, Grade 4: severe pathology) and provided a grade for their confidence for each pathology assessment (Grade 1: high confidence, Grade 2: moderate confidence, Grade 3: limited confidence, Grade 4: no confidence). Interobserver agreement for the presence/absence of pathology and agreement for individual grades of pathology were assessed with Fleiss' kappa (k). Overall interobserver agreement for pathology was determined using Fleiss' kappa and Kendall's coefficient of concordance (KCC). The distribution of grading was also visualised with bubble charts. Results: Interobserver agreement for the presence/absence of pathology of individual anatomical structures was poor-to-fair, except for the navicular bone which had moderate agreement (k = 0.52). Relative agreement for pathology grading (accounting for the ranking of grades) ranged from KCC = 0.19 for the distal interphalangeal joint to KCC = 0.70 for the navicular bone. Agreement was generally greatest at the extremes of pathology. Observer confidence in pathology assessment was generally moderate to high. Conclusions: Distribution of pathology varied between anatomical structures due to random selection of clinical MRI studies. Observers had most experience with low-field MRI. Conclusions: Even with experienced observers, there can be notable variation in the perceived severity of foot pathology on MRI for individual cases, which could be important in a clinical context.
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Publication Date: 2024-06-30 PubMed ID: 38946165DOI: 10.1111/evj.14126Google Scholar: Lookup
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  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research examined the degree of agreement between different experienced observers while assessing pathology in horse foot using Magnetic Resonance Imaging(MRI). The findings indicate that variations in pathology assessments can occur even among experienced observers, which can potentially affect clinical decision-making.

Research Methodology

  • The researchers carried out an exploratory clinical study which included ten experienced observers. These observers were either diploma holders or associates, bringing professional perspectives into the assessment process.
  • The assessment involved 15 horse foot MRI studies viz. the data were drawn from clinical databases of three different MRI systems, thus providing a broad range of sources for the study.
  • For the analysis, the observers were made to grade the pathology in seven central anatomical structures. Four grades were established: Grade 1 for no pathology, Grade 2 for mild pathology, Grade 3 for moderate pathology, and Grade 4 for severe pathology.
  • The observers also had to provide a confidence grade for each of their pathology assessments. It ranged from Grade 1 for high confidence to Grade 4 for no confidence.
  • The interobserver agreement was measured using Fleiss’ kappa coefficient (k), which is a statistical measure for calculating the degree of agreement among observers. The overall interobserver agreement for pathology was determined using Fleiss’ Kappa and Kendall’s coefficient of concordance (KCC).
  • The researchers also used bubble charts to visualize the distribution of grading.

Key Findings

  • Finding showed that the interobserver agreement for the presence or absence of pathology for individual anatomical structures was generally poor-to-fair. Only the evaluation of the navicular bone showed moderate agreement with a kappa score of 0.52.
  • Relative agreement for pathology grading, which accounts for the ranking of grades, varied from a low of 0.19 (for the distal interphalangeal joint) up to 0.70 (for the navicular bone).
  • The agreement was typically highest at the extremes of pathology, that is, when the disease was either very severe or non-existent.
  • Interestingly, observer confidence in pathology assessment was generally moderate to high, despite the evident differences in their pathology evaluations.

Conclusion

  • Pathology distribution varied across different anatomical structures due to the random selection procedure of clinical MRI studies.
  • Most observers had more experience with low-field MRI, which might have influenced their evaluations.
  • The study concluded that even experienced observers can have marked differences in their evaluations of the severity of foot pathology in MRI studies. This discrepancy in perception can have significant implications for clinical decisions.

Cite This Article

APA
Byrne CA, Voute LC, Marshall JF. (2024). Interobserver agreement during clinical magnetic resonance imaging of the equine foot. Equine Vet J, 57(2), 406-418. https://doi.org/10.1111/evj.14126

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 57
Issue: 2
Pages: 406-418

Researcher Affiliations

Byrne, Christian A
  • School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
Voute, Lance C
  • School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
Marshall, John F
  • School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.

MeSH Terms

  • Animals
  • Horses / anatomy & histology
  • Magnetic Resonance Imaging / veterinary
  • Observer Variation
  • Horse Diseases / diagnostic imaging
  • Horse Diseases / pathology
  • Foot Diseases / veterinary
  • Foot Diseases / diagnostic imaging
  • Foot Diseases / pathology
  • Foot / pathology
  • Foot / diagnostic imaging

Grant Funding

  • SPrj033 / Horserace Betting Levy Board

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Citations

This article has been cited 1 times.
  1. Scharf A, Acutt E, Bills K, Werpy N. Magnetic resonance imaging for diagnosing and managing deep digital flexor tendinopathy in equine athletes: Insights, advances and future directions. Equine Vet J 2025 Sep;57(5):1183-1203.
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