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Journal of veterinary internal medicine2014; 28(6); 1860-1870; doi: 10.1111/jvim.12431

Repeatability and intra- and inter-observer agreement of cervical vertebral sagittal diameter ratios in horses with neurological disease.

Abstract: Sagittal ratio values (SRVs) of cervical vertebrae are used for ante-mortem diagnosis of cervical vertebral stenotic myelopathy, but intraobserver and interobserver variability in measurement may influence radiographic interpretation of vertebral stenosis in horses with neurological disease. Objective: To determine intraobserver repeatability in SRVs, intra- and interobserver agreement in SRVs and whether or not agreement was influenced by animal age. Methods: Forty-two horses (>1 year old) with neurological disease from which laterolateral computed radiographic images of C2-C7 were obtained. Methods: Four observers made measurements from C2 to C7 for each horse and interobserver agreement for intra- and intervertebral SRVs was determined using Bland-Altman analysis (acceptable agreement: limits of agreement [LOA] ≤ 0.05) on all horses and those ≤3 (n = 25) and >3 (n = 17) years old. Each observer also made repeated measurements for 10 horses and intraobserver repeatability and agreement were determined. Results: Adequate intraobserver repeatability was achieved for 6 sites. Within observers, paired measurements had a median difference ≤5.7%, but a large range in differences often occurred, most frequently at intervertebral sites. For C5, C6, C7, and C3-4, LOA ≤ 0.05 were achieved by at least 1 observer. With the exception of C5 for 1 pair, LOA were >0.05 for interobserver agreement, regardless of animal age. LOA were largest at intervertebral sites. Conclusions: Within and between observers, measurement error may limit the diagnostic accuracy of SRVs and result in discrepancies of diagnosis and treatment and warrants consideration when used clinically in horses with neurological disease.
Copyright © 2014 by the American College of Veterinary Internal Medicine.
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Publication Date: 2014-11-21 PubMed ID: 25410955PubMed Central: PMC4895627DOI: 10.1111/jvim.12431Google Scholar: Lookup
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  • Journal Article
  • Research Support
  • Non-U.S. Gov't

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 article is about how measurement inaccuracies between different observers, and even the same observer at different times, may limit the diagnostic accuracy of sagittal ratio values for diagnosing cervical vertebral stenotic myelopathy, a neurological disease in horses.

Objectives and Methods

  • The study aimed to assess the repeatability of cervical vertebral sagittal ratio values (SRVs) within the same observer (intraobserver) and the agreement between different observers (interobserver).
  • SRVs are a tool used in the diagnosis of a specific neurologic condition in horses, cervical vertebral stenotic myelopathy.
  • The researchers also wanted to find out if age influenced these measurements.
  • The study involved 42 horses diagnosed with a neurological disease. For all of these horses, computed radiographic images of the cervical vertebrae from C2 to C7 were obtained, and four different observers took measurements.
  • Intra- and inter-observer agreement was determined using a statistical method known as Bland-Altman analysis, where the acceptable limits of agreement (LOA) were set at a maximum difference of 0.05.

Results

  • Intraobserver repeatability was good for each observer in 6 specific sites. The median difference for measurements made by the same observer was less than or equal to 5.7%.
  • However, there was significant variability in these measurements, with a large range of differences often occurring.
  • This inconsistency was seen most frequently at sites between the vertebrae (intervertebral sites).
  • Interobserver agreement was generally unachievable, with LOA exceeding the acceptable 0.05 in all instances apart from one case at C5 vertebrae and at C3-4 intervertebral site.
  • The largest discrepancies between observers were found at intervertebral sites.
  • There was no association found between animal age and agreement in measurements.

Conclusions

  • The research highlights that inconsistencies in measurements, both within the same observer and between different observers, could potentially limit the diagnostic accuracy of SRVs.
  • The authors suggest that these discrepancies could cause confusion or inaccuracies in diagnosing and treating horses with neurological conditions.
  • Therefore, these findings could have important implications for the use of SRVs in veterinary practice and should be taken into account when making clinical decisions related to horses with neurological disease.

Cite This Article

APA
Hughes KJ, Laidlaw EH, Reed SM, Keen J, Abbott JB, Trevail T, Hammond G, Parkin TD, Love S. (2014). Repeatability and intra- and inter-observer agreement of cervical vertebral sagittal diameter ratios in horses with neurological disease. J Vet Intern Med, 28(6), 1860-1870. https://doi.org/10.1111/jvim.12431

Publication

Journal of veterinary internal medicine
ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 28
Issue: 6
Pages: 1860-1870

Researcher Affiliations

Hughes, K J
  • Weipers Centre for Equine Welfare, School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK; School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW, Australia.
Laidlaw, E H
    Reed, S M
      Keen, J
        Abbott, J B
          Trevail, T
            Hammond, G
              Parkin, T D H
                Love, S

                  MeSH Terms

                  • Age Factors
                  • Animals
                  • Cervical Vertebrae / diagnostic imaging
                  • Cervical Vertebrae / pathology
                  • Female
                  • Horse Diseases / diagnosis
                  • Horse Diseases / diagnostic imaging
                  • Horse Diseases / pathology
                  • Horses
                  • Humans
                  • Male
                  • Nervous System Diseases / diagnosis
                  • Nervous System Diseases / diagnostic imaging
                  • Nervous System Diseases / pathology
                  • Nervous System Diseases / veterinary
                  • Observer Variation
                  • Radiography
                  • Reproducibility of Results
                  • Spinal Stenosis / diagnosis
                  • Spinal Stenosis / diagnostic imaging
                  • Spinal Stenosis / pathology
                  • Spinal Stenosis / veterinary

                  Grant Funding

                  • Wellcome Trust

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                  Citations

                  This article has been cited 7 times.
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                  3. Rijckaert J, Pardon B, Van Ham L, Joosten P, van Loon G, Deprez P. Magnetic motor evoked potentials of cervical muscles in horses. BMC Vet Res 2018 Sep 24;14(1):290.
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