Influence of investigator experience on reliability of adult acquired flatfoot deformity measurements using weightbearing computed tomography.
BACKGROUND: Our purpose was to assess the reliability of measurements of adult-acquired flatfoot deformity (AAFD) taken by investigators of different levels of clinical experience using weightbearing computed tomography (WBCT). METHODS: Nineteen AAFD patients underwent WBCT. Three investigators with different levels of clinical experience made AAFD measurements in axial, coronal, and sagittal planes. Intra- and interobserver reliability were assessed. Mean values for each measurement were compared between investigators. RESULTS: After a training protocol, substantial to perfect intra- and interobserver reliability was observed for most measures, regardless of the investigator's experience level. Significant differences between investigators were observed in 2 of 21 measured parameters: medial cuneiform-first metatarsal angle (P=0.003) and navicular-medial cuneiform angle (P=0.001). CONCLUSIONS: AAFD radiographic measurements can be performed reliably by investigators with different levels of clinical experience using WBCT. LEVEL OF EVIDENCE: Level II, prospective comparative study.
de Cesar Netto, C; Shakoor, D; Dein, EJ; Zhang, H; Thawait, GK; Richter, M; Ficke, JR; Schon, LC; Weightbearing CT International Study Group, ; Demehri, S
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