Purpose
The aim of this project is to validate the inter-reader agreement of Kellgren-Lawrence (K/L)scale [1] for knee osteoathritis (OA)among board certified radiologists from 50 countries. To the best of our knowledge, this is the first study that attempts to validate a radiological scale amongst large number of subjects and across many countries using the web as the main tool of communication.
Methods and Materials
This is a prospective multi-institutional survey conducted by University of Nebraska Medical Center (UNMC), University of North Carolina at Chapel Hill (UNC) and Center for Excellence in Surgical Outcomes (CESO), Duke University (DUHS) conducted from July 2008 through July 2009. Institutional review board from UNMC, UNC and DUHS institutions approved this project.Consent was waived given the anonymous survey.Design Potential subjects had been sent an email requesting their participation in an anonymous survey. We had invited radiologists from 50 countries for their participation, but we are...
Results
The inter-observer kappa coefficient for the images ranged from0.21 to 0.40 while the overall Kappa coefficient was 0.221 which is indicative of fair agreement.
Conclusion
Kellgren and Lawrence scale [1] has been designed as a classification to evaluate OA and it has been adopted since 1961 by theWorld Health Organization. K/ L scale has a great impact in the clinical and research setting since it has been globally used in longitudinal and cross sectional OA epidemiological studies.Our results have shown that the inter-reader agreement of K/L grade between board certified radiologists across countries was poor. This result may raise concerns of using this scale widely on epidemiology studies to grade...
References
1. Kellgren JH, Lawrence JS. Radiological Assessment of Osteo-Arthrosis. Ann Rheum Dis. 1957; 16(4):494-502.2. Atashili J; Carvalho E; Pietrobon R, Braga L. Streamlining the improvement of radiological scales for use in clinical and research settings. In press (Neuroinformatics Journal).3. (http://www.cdc.gov/arthritis/funded_science/projects/johnston-county-osteoarthritis-project.htm).4. Landis JR, Koch GG. The Measurement of Observer Agreement for Categorical Data. Biometrics 1977; 33(1):159-74.
Personal Information
1. Larissa Braga, MD, PhD, MPH. Assistant Professor, Department of Radiology, University of Nebraska Medical Center, Omaha, Nebraska, USA.2. Jatin Shah, BAMS. Research Assistant, Duke NUS Graduate Medical School, Singapore.3. Amruta Phadtare, BAMS. Research fellow, Kalpavriksha Healthcare & Research, Thane, India.4. Meenakshi Vaghasia, BAMS. Research fellow, Kalpavriksha Healthcare & Research, Thane, India.5. Sunita Patil, MSc, MBA. Research fellow, Kalpavriksha Healthcare & Research, Thane, India,6. Ricardo Pietrobon, MD, PhD, MBA. Associate Vice chair and Associate Professor, Department of Surgery, Duke University Medical Center, Durham, NC, USA.