Observer agreement study of cervical-vertebral ratios in horses.
Abstract: Different examiners or the same examiner were observed at different times producing slightly different results when obtaining cervical-vertebral ratios. If the difference is substantial, then measurement variability would have an important impact of radiographic interpretation. Objective: To quantify agreement and repeatability of these measurements. Methods: An observer agreement study was performed using 75 horses. Measurements were made at C3-4 and C6-7 by a board-certified radiologist and an imaging resident. Intra- and interobserver agreement was quantified using Bland-Altman plots. Repeatability was assessed as the percentage of differences between duplicate measurements by the radiologist that were within ± 2 s.d. of the differences. Results: At C3-4, the limits of agreement for the intra-vertebral ratio were between -5 and 4% for the intra- and -5 and 6% for interobserver comparison. For the intervertebral ratio, they were between -9 and 8% for the intra- and -10 and 10% for interobserver comparison. At C6-7, the limits of agreement for the intra-vertebral ratio were between -6 and 5% for the intra- and -6 and 8% for interobserver comparison. For the intervertebral ratio, they were between -7 and 7% for the intra- and -6 and 13% for interobserver comparison. At C3-4, all measurements were 95% repeatable (differences typically ≤ 4% and always ≤ 8%) for the intra-vertebral ratio and 96% repeatable (differences typically ≤ 8% and always ≤ 11%) for the intervertebral ratio. At C6-7, all measurements were 98% repeatable (differences typically ≤ 6% and always ≤ 7%) for the intravertebral ratio and 92% repeatable (differences typically ≤ 6% and always ≤ 10%) for the intervertebral ratio. Conclusions: Cervical-vertebral ratios typically varied by 5-10% within and between examiners. Conclusions: When using cervical-vertebral ratios in practice, the impact of measurement agreement should be factored into the interpretation of the test result because measurement variability may lead to misdiagnosis and limit the clinical usefulness of these tests.
© 2010 EVJ Ltd.
Publication Date: 2010-09-29 PubMed ID: 21496073DOI: 10.1111/j.2042-3306.2010.00300.xGoogle Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
- Anatomy
- Clinical Pathology
- Clinical Study
- Comparative Study
- Diagnosis
- Diagnostic Technique
- Disease Diagnosis
- Equine Diseases
- Equine Health
- Horses
- Imaging Techniques
- Measurement Techniques
- Musculoskeletal System
- Observational Study
- Radiology
- Reproducibility of Results
- Vertebrae
- Veterinary Care
- Veterinary Medicine
- Veterinary Practice
- Veterinary Research
Summary
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This research article primarily investigates the consistency of measurements related to cervical-vertebral ratios in horses when recorded by different examiners or by the same examiner at different times. The findings demonstrate that there is a 5-10% variation in these measurements, and that this variation may impact the clinical interpretation of these tests and potentially lead to misdiagnosis.
Objective
The primary aim of this research was to assess the consistency and repeatability of measurements made by different examiners or by the same examiner at different times when assessing cervical-vertebral ratios in horses. The researchers wanted to understand whether these variations could affect clinical interpretation, with a particular focus on how measurement variability could lead to misdiagnosis.
Methods
- The researchers conducted an observer agreement study using 75 horses.
- Measurements were taken at C3-4 and C6-7 by a board-certified radiologist and an imaging resident.
- The researchers used Bland-Altman plots to quantify intra- and interobserver agreement.
- Repeatability of the measurements was evaluated by the percentage of differences among duplicate measurements made by the radiologist that were within ± 2 standard deviations of the differences.
Results
- The researchers found minor variations in both intra- and interobserver agreement for both inter-vertebral and intra-vertebral ratios.
- The repeatability of measurements was high, with all results showing at least 92% repeatability.
- Cervical-vertebral ratios typically varied by 5-10% within and between examiners, highlighting that there is a certain degree of variation even when the same procedure is followed.
Conclusions
The study concluded that the impact of measurement agreement should be a factor when interpreting the outcome of cervical-vertebral ratio tests, as this variability may affect the reliability of these tests. It underscores the importance of bearing in mind this potential for misdiagnosis due to a 5-10% measurement variability and the need to consider this variability when interpreting test outcomes in a clinical setting.
Cite This Article
APA
Scrivani PV, Levine JM, Holmes NL, Furr M, Divers TJ, Cohen ND.
(2010).
Observer agreement study of cervical-vertebral ratios in horses.
Equine Vet J, 43(4), 399-403.
https://doi.org/10.1111/j.2042-3306.2010.00300.x Publication
Researcher Affiliations
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA. pvs2@cornell.edu
MeSH Terms
- Animals
- Cervical Vertebrae / anatomy & histology
- Cervical Vertebrae / diagnostic imaging
- Female
- Horses / anatomy & histology
- Male
- Observer Variation
- Radiography
- Reproducibility of Results
- Spinal Cord Compression / pathology
Citations
This article has been cited 3 times.- Kondo T, Sato F, Tsuzuki N, Watanabe K, Horiuchi N, Kobayashi Y, Yamada K. Characteristic computed tomographic myelography findings in 23 Thoroughbred horses.. J Vet Med Sci 2022 Apr 13;84(4):525-532.
- Kondo T, Sato F, Tsuzuki N, Chen CJ, Yamada K. An objective index for spinal cord compression on computed tomography in Thoroughbred horses.. Vet Med Sci 2022 May;8(3):1072-1078.
- Hughes KJ, Laidlaw EH, Reed SM, Keen J, Abbott JB, Trevail T, Hammond G, Parkin TD, Love S. Repeatability and intra- and inter-observer agreement of cervical vertebral sagittal diameter ratios in horses with neurological disease.. J Vet Intern Med 2014 Nov-Dec;28(6):1860-70.
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