Evaluation of a semi-automated software program for the identification of vertebral fractures in children.

Aim: To assess observer reliability and diagnostic accuracy in children, of a semi-automated six-point technique developed for vertebral fracture (VF) diagnosis in adults, which records percentage loss of vertebral body height.Materials and Methods: Using a semi-automated software program, five obse...

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Publicado en:Clinical Radiology Vol. 72; no. 10; pp. 904.e11 - 90400000000001
Autores principales: Alqahtani, F.F., Messina, F., Kruger, E., Gill, H., Ellis, M., Lang, I., Broadley, P., Offiah, A.C.
Formato: Journal Article
Publicado: Elsevier B.V. Oct2017
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2017
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      pub: Elsevier B.V.
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        10.1016/j.crad.2017.04.010
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        atl: Evaluation of a semi-automated software program for the identification of vertebral fractures in children.
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          Alqahtani, F.F.
          Messina, F.
          Kruger, E.
          Gill, H.
          Ellis, M.
          Lang, I.
          Broadley, P.
          Offiah, A.C.
        affil: Academic Unit of Child Health, University of Sheffield, Sheffield, UK
      sug:
        subj:
          Body Height Physiology
          Spinal Fractures Diagnosis
          Bone Density Physiology
          Diagnosis, Computer Assisted Methods
          Radiography Methods
          Child
          Sensitivity and Specificity
          Spinal Fractures Physiopathology
          Software
          Spine
          Observer Bias
          Male
          Female
          Adolescence
          Algorithms
          Child, Preschool
          Reproducibility of Results
          Spine Physiopathology
          Child: 6-12 years
          Adolescent: 13-18 years
          Child, Preschool: 2-5 years
          Male
          Female
      ab: Aim: To assess observer reliability and diagnostic accuracy in children, of a semi-automated six-point technique developed for vertebral fracture (VF) diagnosis in adults, which records percentage loss of vertebral body height.Materials and Methods: Using a semi-automated software program, five observers independently assessed T4 to L4 from the lateral spine radiographs of 137 children and adolescents for VF. A previous consensus read by three paediatric radiologists using a simplified algorithm-based qualitative technique (i.e., no software involved) served as the reference standard.Results: Of a total of 1,781 vertebrae, 1,187 (67%) were adequately visualised according to three or more observers. Interobserver agreement in vertebral readability for each vertebral level for five observers ranged from 0.05 to 0.47 (95% CI: -0.19, 0.76). Intra-observer agreement using the intraclass correlation coefficient (ICC) ranged from 0.25 to 0.61. The overall sensitivity and specificity were 18% (95% CI: 14-22) and 97% (95% CI: 97-98), respectively.Conclusion: In contrast to adults, the six-point technique assessing anterior, middle, and posterior vertebral height ratios is neither satisfactorily reliable nor sensitive for VF diagnosis in children. Training of the software on paediatric images is required in order to develop a paediatric standard that incorporates not only specific vertebral body height ratios but also the age-related physiological changes in vertebral shape that occur throughout childhood.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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