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Interobserver Agreement of Standing Magnetic Resonance Imaging for Assessment of Deep Digital Flexor Tendon Pathology
Author(s) -
Whitmore J.K.,
Dakin S.G.,
Weller R.,
Mair T.S.,
Sherlock C.E.
Publication year - 2014
Publication title -
equine veterinary journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.82
H-Index - 87
eISSN - 2042-3306
pISSN - 0425-1644
DOI - 10.1111/evj.12323_57
Subject(s) - kappa , medicine , cohen's kappa , magnetic resonance imaging , grading (engineering) , nuclear medicine , lesion , radiology , pathology , mathematics , statistics , civil engineering , geometry , engineering
Reasons for performing study Standing magnetic resonance imaging (s MRI ) is commonly used to evaluate the distal aspect of the deep digital flexor tendon ( DDFT ) of lame horses. There is paucity of information comparing interobserver agreement of this imaging modality. Objectives To determine the interobserver agreement for assessment of the DDFT on s MRI using a newly developed grading system. It was hypothesised that different lesion types would be more frequently observed at different anatomical locations of the DDFT , and that interobserver agreement would be better for the presence of a lesion compared to lesion grading. Study design A retrospective study assessing interobserver agreement.Methods s MRI studies of 40 equine front feet were retrospectively graded by 2 observer teams using a newly developed grading system based on previous studies. Individual DDFT parameters and an overall DDFT grade were scored. A Pearson's Chi‐square test quantified the association between anatomical location and lesion type and interobserver agreement was quantified by calculating weighted‐kappa statistic. Results Observer team B found a statistically significant association between anatomical location and lesion type but observer team A did not. Interobserver agreement was fair to moderate for the majority of individual DDFT parameters. For most parameters, better interobserver agreement was found for presence of a lesion than for lesion grading. Interobserver agreement was fair for the overall DDFT grade. Conclusions Interobserver agreement was acceptable for overall DDFT grade and was better for the presence of an overall grade. Interobserver agreement was also acceptable for most DDFT parameters and was better for assessing whether a lesion was present compared to the grading of lesions. This study highlights the value of a standardised grading system for assessing the DDFT on s MRI , and provides a method to improve the repeatibilty and reliability of future studies using s MRI . Ethical animal research: This project was granted ethical approval by the RVC Ethics and Welfare Committee as part of J ames W hitmore's final year research project. Explicit owner informed consent for participation in this study was not stated. Sources of funding: None. Competing interests: None.