Radiographic diagnosis of scapholunate dissociation among intra-articular fractures of the distal radius: Interobserver reliability

Science of Variation Group

doi:10.1016/j.jhsa.2013.05.039

Radiographic diagnosis of scapholunate dissociation among intra-articular fractures of the distal radius: Interobserver reliability

Science of Variation Group

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

© 2013 by the American Society for Surgery of the Hand. All rights reserved.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.

Original language	English
Pages (from-to)	1685-1690
Journal	Journal of Hand Surgery
Volume	38
Issue number	9
DOIs	https://doi.org/10.1016/j.jhsa.2013.05.039
Publication status	Published - 1 Sept 2013
Externally published	Yes

Access to Document

10.1016/j.jhsa.2013.05.039

Persistent URL (handle)

Persistent link

Cite this

@article{ab7ddcfe9206451e9a0b8f580084c54e,

title = "Radiographic diagnosis of scapholunate dissociation among intra-articular fractures of the distal radius: Interobserver reliability",

abstract = "{\textcopyright} 2013 by the American Society for Surgery of the Hand. All rights reserved.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.",

author = "G. Gradl and V. Neuhaus and T. Fuchsberger and T.G. Guitton and K.-J. Prommersberger and D. Ring and A.L. Wahegaonkar and A.B. Shafritz and A.E. Garcia and A.E. Caputo and A.L. Terrono and A.B. Spoor and A. Eschler and A.J.H. Vochteloo and A. Beumer and A. Barquet and A. Kristan and \{Van Der Zwan\}, A.L. and A. Berner and A. Ilyas and A. Jubel and B. Sutker and B.M. Nolan and B. Petrisor and B.J. Cross and B.P.D. Wills and C.J.R. Barreto and C.H. Fernandes and C. Swigart and C. Zalavras and C.A. Goldfarb and C. Cassidy and C. Eaton and C. Wilson and C.J. Cheng and C.J. Wall and C.J. Walsh and C.M. Jones and C. Garnavos and C. Young and C. Klostermann and D.K. Kirkpatrick and D.A. Osei and D.A. Rikli and D.C. Wascher and D. Polatsch and D.M. Silva and D.L. Nelson and D.M. Kalainov and D. Ruchelsman and D.V. Hoffmann and D. Weiss and D. Eygendaal and \{Van Deurzen\}, D.F.P. and D.M. McKee and D.O.F. Verbeek and D. Hanel and D.T. Hutchinson and D. Brilej and E. Harvey and E.S. Pemovska and E. Calvo and E.M. Hammerberg and E.P. Hofmeister and F.T.D. Kaplan and F. Suarez and F.J.P. Beeres and F.L. Walter and G.K. Frykman and G.M. Pess and G.R. Kuzma and G.S.M. Dyer and G. Thomas and G. Kohut and G.A. Kraan and G. DeSilva and \{Della Rocca\}, G.J. and G. Lob and G. Gadbled and H.B. Bamberger and H. McCutchan and H. Goost and H.J. Kreder and H. Gr{\"u}nwald and H. Broekhuyse and H.L. Kimball and H. Durchholz and \{Van Der Heide\}, H. and I. McGraw and J. Choueka and J.E. Forigua and J.F. Nappi and J.G. Reid and J. Kellam and J.M. Boler and J. Biert and J.C. Fanuele and J.D. Tavakolian and J. Jones and J.W. Johnson and J.M. Wolf and J. Murachovsky and J.H. Scheer and J.M. Rueger and J.M. Erickson and J. McAuliffe and J.G. Boretto and J. Rubio and J.A. Ortiz and J.E.G.R. Filho and \{DI Giovanni\}, J.F. and J.A. Izzi and J.M. Conflitti and J.M. Abzug and J.C. Cagnone and J. Adams and K. Chivers and K. Lee and K. Eng and K.J. Malone and K. Erol and K.J. Ponsen and K. Kabir and K. Jeray and L. Mica and L.M. Brunton and L.E. Adolfsson and L. Weiss and L. Katolik and L. Paz and L.M.S.J. Poelhekke and L.F.N. Escobar and L.A.B. Campinhos and M.I. Abdel-Ghany and M.J. Richard and M. Swiontkowski and M. Rizzo and M. Pirpiris and M. Boyer and M. Richardson and M. Kastelec and M. Turina and M. Soong and M.M. Wood and M. Baskies and M. Behrman and M. Nancollas and M. Prayson and M. Quell and M. Verhofstad and M.W. Grafe and M.W. Kessler and \{Van Den Bekerom\}, M.P.J. and \{Van De Sande\}, M.A.J. and M. McKee and M.M. Patel and M. Merchant and M. Tyllianakis and M.R. Wiegand and M. Waseem and N. Parnes and N. Wilson and N. Elias and N.L. Shortt and N. Schep and O.M. Semenkin and P.D.G. Henry and P.A. Martineau and P. Jebson and P. Kloen and P.R.G. Brink and P. Schandelmaier and P. Blazar and P.N. Streubel and P. Vial and P. Choudhari and P. Inna and R.M. Costanzo and \{De Bedout\}, R. and R. Hauck and R.M. Smith and R.M. Fricker and R. Omid and R. Buckley and R. Jenkinson and R.L. Hutchison and R.S. Gilbert and R.S. Page and R. Nelissen and R. Haverlag and R. Wagenmakers and R. Pesantez and R. Klinefelter and R.P. Calfee and S. Moghtaderi and S. Spruijt and S. Kakar and S. Kaplan and S.F. Duncan and S. Mitchell and S. Rowinski and S. Dodds and S.A. Kennedy and S.K. Westly and S. Kronlage and S. Beldner and S.J. McCabe and S.J. Rhemrev and T. Gosens and T. Baxamusa and T. Apard and T. DIenstknecht and T.F. Varecka and T. Hughes and T. Mittlmeier and T. Pillukat and T. Wright and T.G. Havenhill and T. Omara and T. Siff and V. Giordano and W.C. Hammert and W. Satora and \{Science of Variation Group\}",

year = "2013",

month = sep,

day = "1",

doi = "10.1016/j.jhsa.2013.05.039",

language = "English",

volume = "38",

pages = "1685--1690",

journal = "Journal of Hand Surgery",

issn = "0363-5023",

publisher = "W.B. Saunders",

number = "9",

}

TY - JOUR

T1 - Radiographic diagnosis of scapholunate dissociation among intra-articular fractures of the distal radius

T2 - Interobserver reliability

AU - Gradl, G.

AU - Neuhaus, V.

AU - Fuchsberger, T.

AU - Guitton, T.G.

AU - Prommersberger, K.-J.

AU - Ring, D.

AU - Wahegaonkar, A.L.

AU - Shafritz, A.B.

AU - Garcia, A.E.

AU - Caputo, A.E.

AU - Terrono, A.L.

AU - Spoor, A.B.

AU - Eschler, A.

AU - Vochteloo, A.J.H.

AU - Beumer, A.

AU - Barquet, A.

AU - Kristan, A.

AU - Van Der Zwan, A.L.

AU - Berner, A.

AU - Ilyas, A.

AU - Jubel, A.

AU - Sutker, B.

AU - Nolan, B.M.

AU - Petrisor, B.

AU - Cross, B.J.

AU - Wills, B.P.D.

AU - Barreto, C.J.R.

AU - Fernandes, C.H.

AU - Swigart, C.

AU - Zalavras, C.

AU - Goldfarb, C.A.

AU - Cassidy, C.

AU - Eaton, C.

AU - Wilson, C.

AU - Cheng, C.J.

AU - Wall, C.J.

AU - Walsh, C.J.

AU - Jones, C.M.

AU - Garnavos, C.

AU - Young, C.

AU - Klostermann, C.

AU - Kirkpatrick, D.K.

AU - Osei, D.A.

AU - Rikli, D.A.

AU - Wascher, D.C.

AU - Polatsch, D.

AU - Silva, D.M.

AU - Nelson, D.L.

AU - Kalainov, D.M.

AU - Ruchelsman, D.

AU - Hoffmann, D.V.

AU - Weiss, D.

AU - Eygendaal, D.

AU - Van Deurzen, D.F.P.

AU - McKee, D.M.

AU - Verbeek, D.O.F.

AU - Hanel, D.

AU - Hutchinson, D.T.

AU - Brilej, D.

AU - Harvey, E.

AU - Pemovska, E.S.

AU - Calvo, E.

AU - Hammerberg, E.M.

AU - Hofmeister, E.P.

AU - Kaplan, F.T.D.

AU - Suarez, F.

AU - Beeres, F.J.P.

AU - Walter, F.L.

AU - Frykman, G.K.

AU - Pess, G.M.

AU - Kuzma, G.R.

AU - Dyer, G.S.M.

AU - Thomas, G.

AU - Kohut, G.

AU - Kraan, G.A.

AU - DeSilva, G.

AU - Della Rocca, G.J.

AU - Lob, G.

AU - Gadbled, G.

AU - Bamberger, H.B.

AU - McCutchan, H.

AU - Goost, H.

AU - Kreder, H.J.

AU - Grünwald, H.

AU - Broekhuyse, H.

AU - Kimball, H.L.

AU - Durchholz, H.

AU - Van Der Heide, H.

AU - McGraw, I.

AU - Choueka, J.

AU - Forigua, J.E.

AU - Nappi, J.F.

AU - Reid, J.G.

AU - Kellam, J.

AU - Boler, J.M.

AU - Biert, J.

AU - Fanuele, J.C.

AU - Tavakolian, J.D.

AU - Jones, J.

AU - Johnson, J.W.

AU - Wolf, J.M.

AU - Murachovsky, J.

AU - Scheer, J.H.

AU - Rueger, J.M.

AU - Erickson, J.M.

AU - McAuliffe, J.

AU - Boretto, J.G.

AU - Rubio, J.

AU - Ortiz, J.A.

AU - Filho, J.E.G.R.

AU - DI Giovanni, J.F.

AU - Izzi, J.A.

AU - Conflitti, J.M.

AU - Abzug, J.M.

AU - Cagnone, J.C.

AU - Adams, J.

AU - Chivers, K.

AU - Lee, K.

AU - Eng, K.

AU - Malone, K.J.

AU - Erol, K.

AU - Ponsen, K.J.

AU - Kabir, K.

AU - Jeray, K.

AU - Mica, L.

AU - Brunton, L.M.

AU - Adolfsson, L.E.

AU - Weiss, L.

AU - Katolik, L.

AU - Paz, L.

AU - Poelhekke, L.M.S.J.

AU - Escobar, L.F.N.

AU - Campinhos, L.A.B.

AU - Abdel-Ghany, M.I.

AU - Richard, M.J.

AU - Swiontkowski, M.

AU - Rizzo, M.

AU - Pirpiris, M.

AU - Boyer, M.

AU - Richardson, M.

AU - Kastelec, M.

AU - Turina, M.

AU - Soong, M.

AU - Wood, M.M.

AU - Baskies, M.

AU - Behrman, M.

AU - Nancollas, M.

AU - Prayson, M.

AU - Quell, M.

AU - Verhofstad, M.

AU - Grafe, M.W.

AU - Kessler, M.W.

AU - Van Den Bekerom, M.P.J.

AU - Van De Sande, M.A.J.

AU - McKee, M.

AU - Patel, M.M.

AU - Merchant, M.

AU - Tyllianakis, M.

AU - Wiegand, M.R.

AU - Waseem, M.

AU - Parnes, N.

AU - Wilson, N.

AU - Elias, N.

AU - Shortt, N.L.

AU - Schep, N.

AU - Semenkin, O.M.

AU - Henry, P.D.G.

AU - Martineau, P.A.

AU - Jebson, P.

AU - Kloen, P.

AU - Brink, P.R.G.

AU - Schandelmaier, P.

AU - Blazar, P.

AU - Streubel, P.N.

AU - Vial, P.

AU - Choudhari, P.

AU - Inna, P.

AU - Costanzo, R.M.

AU - De Bedout, R.

AU - Hauck, R.

AU - Smith, R.M.

AU - Fricker, R.M.

AU - Omid, R.

AU - Buckley, R.

AU - Jenkinson, R.

AU - Hutchison, R.L.

AU - Gilbert, R.S.

AU - Page, R.S.

AU - Nelissen, R.

AU - Haverlag, R.

AU - Wagenmakers, R.

AU - Pesantez, R.

AU - Klinefelter, R.

AU - Calfee, R.P.

AU - Moghtaderi, S.

AU - Spruijt, S.

AU - Kakar, S.

AU - Kaplan, S.

AU - Duncan, S.F.

AU - Mitchell, S.

AU - Rowinski, S.

AU - Dodds, S.

AU - Kennedy, S.A.

AU - Westly, S.K.

AU - Kronlage, S.

AU - Beldner, S.

AU - McCabe, S.J.

AU - Rhemrev, S.J.

AU - Gosens, T.

AU - Baxamusa, T.

AU - Apard, T.

AU - DIenstknecht, T.

AU - Varecka, T.F.

AU - Hughes, T.

AU - Mittlmeier, T.

AU - Pillukat, T.

AU - Wright, T.

AU - Havenhill, T.G.

AU - Omara, T.

AU - Siff, T.

AU - Giordano, V.

AU - Hammert, W.C.

AU - Satora, W.

AU - Science of Variation Group

PY - 2013/9/1

Y1 - 2013/9/1

N2 - © 2013 by the American Society for Surgery of the Hand. All rights reserved.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 - © 2013 by the American Society for Surgery of the Hand. All rights reserved.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.

U2 - 10.1016/j.jhsa.2013.05.039

DO - 10.1016/j.jhsa.2013.05.039

M3 - Article

SN - 0363-5023

VL - 38

SP - 1685

EP - 1690

JO - Journal of Hand Surgery

JF - Journal of Hand Surgery

IS - 9

ER -

Radiographic diagnosis of scapholunate dissociation among intra-articular fractures of the distal radius: Interobserver reliability

Abstract

Access to Document

Persistent URL (handle)

Fingerprint

Cite this