Document Detail

Ultrasonography of the hip in developmental hip dysplasia.
MedLine Citation:
PMID:  9546469     Owner:  NLM     Status:  MEDLINE    
Ultrasonography of the hip was performed sequentially by two different examiners in 75 infants. The ultrasound strips were reviewed twice by three paediatric orthopaedic surgeons and classified by the Graf method. The intraobserver and interobserver agreement between the interpretations was analysed using simple and weighted kappa coefficients calculated for agreement on the Graf classification and for grouping as normal (types 1A to 2A), and abnormal requiring treatment (types 2B to 4). When examining the same ultrasound strip, intraobserver agreement for the Graf classification was substantial (mean kappa 0.61), but interobserver agreement was only moderate (kappa 0.50). For the grouping into normal and abnormal, the mean kappa value for intraobserver agreement was 0.67 and for interobserver agreement 0.57. Because of the significant differences in agreement between normal and abnormal hips, we analysed a subgroup of those with at least one abnormal interpretation. Intraobserver agreement within this subgroup showed moderate reliability (kappa 0.41), but interobserver agreement was only fair (kappa 0.28). Interpretations of two different strips performed sequentially showed significantly lower agreement with an intraobserver kappa value of 0.29 and an interobserver value of 0.28. In the subgroup with at least one abnormal reading, the intraobserver kappa was 0.09 and the interobserver 0.1. Our findings suggest that both the technique of performing ultrasonography and the interpretation of the image may influence the result.
E Bar-On; S Meyer; G Harari; S Porat
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of bone and joint surgery. British volume     Volume:  80     ISSN:  0301-620X     ISO Abbreviation:  J Bone Joint Surg Br     Publication Date:  1998 Mar 
Date Detail:
Created Date:  1998-04-30     Completed Date:  1998-04-30     Revised Date:  2010-11-10    
Medline Journal Info:
Nlm Unique ID:  0375355     Medline TA:  J Bone Joint Surg Br     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  321-4     Citation Subset:  AIM; IM    
Schneider Children's and Rabin Medical Center, Petah Tikva, Israel.
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MeSH Terms
Hip Dislocation, Congenital / classification,  ultrasonography*
Hip Joint / ultrasonography*
Infant, Newborn
Medical History Taking
Observer Variation
Physical Examination
Reproducibility of Results
Single-Blind Method
Comment In:
J Bone Joint Surg Br. 1999 Jan;81(1):179   [PMID:  10068030 ]

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