Reliability assessment of the Biffl Scale for blunt traumatic cerebrovascular injury as detected on computer tomography angiography
| Autor: | Matthew R. Fusco, Philip G.R. Schmalz, John P. Deveikis, Brandon G. Rocque, Joseph C. Sullivan, Paul M. Foreman, Christoph J. Griessenauer, Kimberly P. Kicielinski, Mark R. Harrigan |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Computed Tomography Angiography Interclass correlation Wounds Nonpenetrating 03 medical and health sciences Injury Severity Score 0302 clinical medicine Blunt Humans Medicine Cerebrovascular Trauma Prospective Studies Observer Variation medicine.diagnostic_test business.industry Reproducibility of Results 030208 emergency & critical care medicine General Medicine Intra-rater reliability Digital subtraction angiography Inter-rater reliability Angiography Radiology Tomography business 030217 neurology & neurosurgery Kappa |
| Zdroj: | Journal of Neurosurgery. 127:32-35 |
| ISSN: | 1933-0693 0022-3085 |
| DOI: | 10.3171/2016.7.jns16849 |
| Popis: | OBJECTIVEBlunt traumatic cerebrovascular injury (TCVI) represents structural injury to a vessel due to high-energy trauma. The Biffl Scale is a widely accepted grading scheme for these injuries that was developed using digital subtraction angiography. In recent years, screening CT angiography (CTA) has been used to identify patients with TCVI. The reliability of this scale, with injuries assessed using CTA, has not yet been determined.METHODSSeven independent raters, including 2 neurosurgeons, 2 neuroradiologists, 2 neurosurgical residents, and 1 neurosurgical vascular fellow, independently reviewed each presenting CTA of the neck performed in 40 patients with confirmed TCVI and assigned a Biffl grade. Ten images were repeated to assess intrarater reliability, for a total of 50 CTAs. Fleiss' multirater kappa (κ) and interclass correlation were calculated as a measure of interrater reliability. Weighted Cohen's κ was used to assess intrarater reliability.RESULTSFleiss' multirater κ was 0.65 (95% CI 0.61–0.69), indicating substantial agreement as to the Biffl grade assignment among the 7 raters. Interclass correlation was 0.82, demonstrating excellent agreement among the raters. Intrarater reliability was perfect (weighted Cohen's κ = 1) in 2 raters, and near perfect (weighted Cohen's κ > 0.8) in the remaining 5 raters.CONCLUSIONSGrading of TCVI with CTA using the Biffl Scale is reliable. |
| Databáze: | OpenAIRE |
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