Linked Life Data

17396260

Source:http://linkedlifedata.com/resource/pubmed/id/17396260

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
3
pubmed:dateCreated
2008-4-21
pubmed:abstractText
Diagnosis of avascular necrosis (AVN) of the femoral head depends on the combination of clinical symptoms and evaluation of radiographs and/or magnetic resonance imaging (MRI). To evaluate the evolution of AVN, the Ficat and the Association Research Circulation Osseous (ARCO) classification are commonly used to assess both imaging modalities. For comparison reasons, these classifications need to be reliable and reproducible to provide sufficient therapy options for the patient. Therefore, the aim of our study was to evaluate the interobserver reliability and the intraobserver reproducibility of these classifications. Patients with suspected AVN were examined using either radiographs or radiographs and MRI. The radiographs and/or MR images were reviewed initially and at 3 months by two general orthopaedic surgeons, two orthopaedic residents, and two general radiologists using the Ficat classification for radiographs and MR images as well as the ARCO classification for MR images only. In all, 38 patients (54 hips) were enrolled. There were 10 patients who presented with radiographs and 28 patients with radiographs and MR scans. Paired comparisons revealed a mean interobserver kappa reliability coefficient of 0.39 for the first and of 0.32 for the second review using the Ficat classification for radiographs, whereas for the MR images a mean of 0.39 in the first and of 0.34 in the second reading resulted. The MRI evaluation using the ARCO classification resulted in a mean interobserver reliability coefficient of 0.37 in the first and of 0.31 in the second reading. The mean kappa value for intraobserver reproducibility using the Ficat classification was 0.52 for radiographs and 0.50 for MR images, whereas a reproducibility of 0.43 resulted for the ARCO classification. This study showed poor interobserver reliability and fair intraobserver variability, diminishing any meaningful comparison of studies using the Ficat as well as the ARCO classification. Thus, the Ficat and ARCO staging systems are still not sufficient to reliably assess the status of AVN alone.
pubmed:commentsCorrections
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pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Jun
pubmed:issn
0341-2695
pubmed:author
pubmed:issnType
Print
pubmed:volume
32
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
283-7
pubmed:dateRevised
2009-11-18
pubmed:meshHeading
pubmed:year
2008
pubmed:articleTitle
Avascular necrosis of the femoral head: inter- and intraobserver variations of Ficat and ARCO classifications.
pubmed:affiliation
Department of Orthopedic Surgery, University Hospital Grosshadern, Marchioninistrasse 15, 81377 Munich, Germany. mschmitt@med.uni-muenchen.de
pubmed:publicationType
Journal Article, Evaluation Studies