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Current Medical Imaging

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ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

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Research Article

Validity of Radiographic Analyses Between Hand-Drawn and Computer- Aided Measurements: A Double-Blinded Test-Retest Trial

Author(s): Curtis Fedorchuk*, Robert D. Comer, Christi McRae, David Bak and Douglas F. Lightstone

Volume 19, Issue 9, 2023

Published on: 14 February, 2023

Article ID: e060223213470 Pages: 8

DOI: 10.2174/1573405619666230206155900

Price: $65

Abstract

Background: Spinal radiographic analyses are valid and reliable practices used for patient management in healthcare. Technologies and tools used for these analyses need to be valid and reliable.

Objective: This study investigates repeated accuracy for validity and intra- and inter-examiner reliability of computer-aided lateral spinal radiograph measurements using PostureRay® EMR software.

Methods: Rectangle renderings representing lateral spinal radiographic views were created to remove examiner interpretation of anatomical landmarks as performed on actual radiographs to examine the objective repeated accuracy of PostureRay® software. A blind, randomized, repeated measure design was performed using four examiners trained and experienced with the Harrison Posterior Tangent method of measurement. Each examiner analyzed the spine renderings using a hand-drawn and PostureRay ® method multiple times. A fully crossed design whereby examiners performed multiple assessments per rendering using each analysis method was used to assess intra- and inter-examiner reliability within each method and a formal comparison of the two methods.

Results: Using hand-drawn and PostureRay® methods, examiners displayed very high intra-examiner reliability with correlation values greater than 0.999 for each combination of trials. PostureRay® method showed consistent accuracy of measurements. Further, there was no statistical difference in average concordance between hand-drawn and PostureRay® methods for the lateral cervical, thoracic, and thoracolumbosacral spinal regions.

Conclusion: This study reports a very high degree of intra- and inter-examiner reliability of radiographic line drawing methods and establishes concurrent validity of PostureRay® EMR software in determining angles and displacements of lateral spinal alignment as an equivalent method to the handdrawn method.

Graphical Abstract

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