Interrater and intrarater reliability of four different classification methods for evaluating acromial morphology on standardized radiographs
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Interrater and intrarater reliability of four different classification methods for evaluating acromial morphology on standardized radiographs. / Mayntzhusen, Thomas W.; Witten, Adam; Gramkow, Jens; Hansen, Sanja B.; Chatterjee, Shefali A.; Hölmich, Per; Barfod, Kristoffer W.
I: JSES International, Bind 7, Nr. 3, 2023, s. 445-449.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Interrater and intrarater reliability of four different classification methods for evaluating acromial morphology on standardized radiographs
AU - Mayntzhusen, Thomas W.
AU - Witten, Adam
AU - Gramkow, Jens
AU - Hansen, Sanja B.
AU - Chatterjee, Shefali A.
AU - Hölmich, Per
AU - Barfod, Kristoffer W.
N1 - Publisher Copyright: © 2023 The Author(s)
PY - 2023
Y1 - 2023
N2 - Background: Acromial morphology is an important pathophysiological factor for the development of subacromial impingement syndrome. There are 3 radiological methods to evaluate acromial morphology: Bigliani, modified Epstein, and acromial angle. However, their reliability have not been compared in a single study, nor using standardized radiographs. Consequently, the evaluation of acromial morphology is currently not validated though its widespread use across the world. The objective of this study was to investigate reliability of the 3 known classifications and the novel Copenhagen Acromial Curve classification. Methods: Three experienced clinicians rated 102 standardized supraspinatus outlet view radiographs with the 4 classification methods in 2 separate sessions a month apart. All measurements were blinded. With an expected kappa (κ) and intraclass correlation coefficient (ICC) > 0.7 (+/−0.15), the target sample size was 87 radiographs. Results: The Bigliani classification had interrater and intrarater reliability ranging from fair to good (κ 0.32-0.41 and 0.26-0.62). The modified Epstein classification had fair to good interrater and intrarater reliability (κ 0.24-0.69 and 0.57-0.63). The acromial angle classification had moderate to good interrater and intrarater reliability (κ 0.53-0.60 and 0.59-0.72). The novel Copenhagen Acromial Curve classification showed moderate to good interrater and intrarater reliability (ICC 0.66-0.71 and 0.75-0.78, respectively). Conclusion: The Copenhagen Acromial Curve was the only classification method with an ICC value > 0.7. The popular Bigliani classification had the worst reliability. The Copenhagen Acromial Curve classification produces numerical data, as opposed to the other 3 classification methods. This could potentially be utilized in future research to establishing cut-off values for treatment stratification.
AB - Background: Acromial morphology is an important pathophysiological factor for the development of subacromial impingement syndrome. There are 3 radiological methods to evaluate acromial morphology: Bigliani, modified Epstein, and acromial angle. However, their reliability have not been compared in a single study, nor using standardized radiographs. Consequently, the evaluation of acromial morphology is currently not validated though its widespread use across the world. The objective of this study was to investigate reliability of the 3 known classifications and the novel Copenhagen Acromial Curve classification. Methods: Three experienced clinicians rated 102 standardized supraspinatus outlet view radiographs with the 4 classification methods in 2 separate sessions a month apart. All measurements were blinded. With an expected kappa (κ) and intraclass correlation coefficient (ICC) > 0.7 (+/−0.15), the target sample size was 87 radiographs. Results: The Bigliani classification had interrater and intrarater reliability ranging from fair to good (κ 0.32-0.41 and 0.26-0.62). The modified Epstein classification had fair to good interrater and intrarater reliability (κ 0.24-0.69 and 0.57-0.63). The acromial angle classification had moderate to good interrater and intrarater reliability (κ 0.53-0.60 and 0.59-0.72). The novel Copenhagen Acromial Curve classification showed moderate to good interrater and intrarater reliability (ICC 0.66-0.71 and 0.75-0.78, respectively). Conclusion: The Copenhagen Acromial Curve was the only classification method with an ICC value > 0.7. The popular Bigliani classification had the worst reliability. The Copenhagen Acromial Curve classification produces numerical data, as opposed to the other 3 classification methods. This could potentially be utilized in future research to establishing cut-off values for treatment stratification.
KW - Acromion
KW - Basic Science Study
KW - Classification
KW - Interrater
KW - Intrarater
KW - Morphology
KW - Reliability
KW - Supraspinatus outlet view
KW - Validation of Classification System
U2 - 10.1016/j.jseint.2023.02.004
DO - 10.1016/j.jseint.2023.02.004
M3 - Journal article
C2 - 37266167
AN - SCOPUS:85151515986
VL - 7
SP - 445
EP - 449
JO - JSES International
JF - JSES International
SN - 2666-6383
IS - 3
ER -
ID: 365818965