Reliability of lower limb alignment measures using an established landmark-based method with a customized computer software program
Reliability of lower limb alignment measures using an established landmark-based method with a customized computer software program
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DOI：
10.1007/s00296-009-1236-5
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发表时间：
2011-01-01
影响因子：
4
通讯作者：
Cooke, T. Derek V.
中科院分区：
文献类型：
--
作者：
Sled, Elizabeth A.;Sheehy, Lisa M.;Cooke, T. Derek V.
该研究的目的是使用基于地标的方法评估额面下肢对齐测量的可靠性，方法是：（1）比较手动获得的对齐测量值与使用计算机程序获得的对齐测量值之间的读者间和读者内可靠性，以及（2）确定全肢射线照片计算机辅助对齐测量的读者间和读者内可靠性。使用了一种既定的测量对准的方法，包括选择 10 个股骨和胫骨标志。 (1) 为了比较手动方法和计算机方法，我们使用数字图像和匹配的五种对齐图案的纸质副本来模拟使用 AutoCAD 绘制的健康和畸形肢体。每个系统有七位读者接受了培训。手动测量纸质副本，并在 3 天内每天进行重复测量，然后使用计算机对数字图像进行类似的例程。 (2) 为了检查全肢 X 光照片计算机辅助测量的可靠性，从多中心骨关节炎研究的 1,500 张全肢数字 X 光照片中随机选择 100 张图像（200 个肢体）作为样本。三位经过培训的读者使用该软件程序对 100 张图像批次中的对齐情况进行了两次测量，批次处理之间间隔两周或更长时间。手动和计算机的对齐测量显示出极好的一致性（计算机分析的组内相关性 [ICC] 0.977-0.999；手动测量的组内相关性 [ICC] 0.820-0.995）。应用于全肢放射线照片的计算机程序产生的对准测量具有较高的读取器间和读取器内可靠性（ICC 0.839-0.998）。总之，使用基于骨标志的方法和计算机程序的对齐测量在多个读取器之间高度可靠。
The objective of the study was to evaluate the reliability of frontal plane lower limb alignment measures using a landmark-based method by (1) comparing inter- and intra-reader reliability between measurements of alignment obtained manually with those using a computer program, and (2) determining inter- and intra-reader reliability of computer-assisted alignment measures from full-limb radiographs. An established method for measuring alignment was used, involving selection of 10 femoral and tibial bone landmarks. (1) To compare manual and computer methods, we used digital images and matching paper copies of five alignment patterns simulating healthy and malaligned limbs drawn using AutoCAD. Seven readers were trained in each system. Paper copies were measured manually and repeat measurements were performed daily for 3 days, followed by a similar routine with the digital images using the computer. (2) To examine the reliability of computer-assisted measures from full-limb radiographs, 100 images (200 limbs) were selected as a random sample from 1,500 full-limb digital radiographs which were part of the Multicenter Osteoarthritis Study. Three trained readers used the software program to measure alignment twice from the batch of 100 images, with two or more weeks between batch handling. Manual and computer measures of alignment showed excellent agreement (intraclass correlations [ICCs] 0.977-0.999 for computer analysis; 0.820-0.995 for manual measures). The computer program applied to full-limb radiographs produced alignment measurements with high inter- and intra-reader reliability (ICCs 0.839-0.998). In conclusion, alignment measures using a bone landmark-based approach and a computer program were highly reliable between multiple readers.