Three-dimensional models increase the interobserver agreement for the treatment of proximal humerus fractures
Abstract Background The agreement for the treatment of proximal humerus fractures is low. Interpretation of exams used for diagnosis can be directly associated with this limitation. This study proposes to compare the agreement between experts and residents in orthopedics for treatment indication of...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-08-01
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| Series: | Patient Safety in Surgery |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13037-020-00258-2 |
| _version_ | 1828860760051154944 |
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| author | Luiz Fernando Cocco André Yui Aihara Carlos Franciozi Fernando Baldy dos Reis Marcus Vinicius Malheiro Luzo |
| author_facet | Luiz Fernando Cocco André Yui Aihara Carlos Franciozi Fernando Baldy dos Reis Marcus Vinicius Malheiro Luzo |
| author_sort | Luiz Fernando Cocco |
| collection | DOAJ |
| description | Abstract Background The agreement for the treatment of proximal humerus fractures is low. Interpretation of exams used for diagnosis can be directly associated with this limitation. This study proposes to compare the agreement between experts and residents in orthopedics for treatment indication of proximal humerus fractures, utilizing 3D-models, holography (augmented reality), x-rays, and tomography as diagnostic methods. Methods Twenty orthopedists (ten experts in shoulder and elbow surgery and ten experts in traumatology) and thirty resident physicians in orthopedics evaluated nine fractures of the proximal humerus, randomly distributed as x-rays, tomography, 3D-models and holography, using the Neer and AO / OTA Classifications. After, we evaluated the interobserver agreement between treatment options (conservative, osteosynthesis and arthroplasty) and whether the experience of the evaluators interfered with the results. Results The interobserver agreement analysis showed the following kappa-values: κ = 0.362 and κ = 0.306 for experts and residents (3D-models); κ = 0.240 and κ = 0.221 (X-ray); κ = 0.233 and κ = 0.123 (Tomography) and κ = 0.321 and κ = 0.160 (Holography), for experts and residents respectively. Moreover, residents and specialists were discordant in the treatment indication using Tomography as a diagnostic method (p = 0.003). The same was not seen for the other diagnostic methods (p > 0.05). Conclusions Three-dimensional models showed, overall, the highest interobserver agreement (experts versus residents in orthopedics) for the choice of treatment of proximal humerus fractures compared to X-ray, Tomography, and Holography. Agreement in the choice of treatment among experts that used Tomography and Holography as diagnostic methods were two times higher compared to residents. Trial registration Registered in Brazil Platform under no. CAAE 12273519.7.0000.5505 . |
| first_indexed | 2024-12-13T02:46:41Z |
| format | Article |
| id | doaj.art-4fe8b48bd1ed4efab4d17ad19707005a |
| institution | Directory Open Access Journal |
| issn | 1754-9493 |
| language | English |
| last_indexed | 2024-12-13T02:46:41Z |
| publishDate | 2020-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Patient Safety in Surgery |
| spelling | doaj.art-4fe8b48bd1ed4efab4d17ad19707005a2022-12-22T00:02:10ZengBMCPatient Safety in Surgery1754-94932020-08-0114111010.1186/s13037-020-00258-2Three-dimensional models increase the interobserver agreement for the treatment of proximal humerus fracturesLuiz Fernando Cocco0André Yui Aihara1Carlos Franciozi2Fernando Baldy dos Reis3Marcus Vinicius Malheiro Luzo4Orthopedics Center from Hospital Samaritano, Americas Medical ServiceDepartment of Diagnostic Imaging, UNIFESPDepartment of Orthopedics and Traumatology, (DOT/UNIFESP) - Escola Paulista de Medicina, Universidade Federal de São PauloDepartment of Orthopedics and Traumatology, (DOT/UNIFESP) - Escola Paulista de Medicina, Universidade Federal de São PauloOrthopedics Center from Hospital Samaritano, Americas Medical ServiceAbstract Background The agreement for the treatment of proximal humerus fractures is low. Interpretation of exams used for diagnosis can be directly associated with this limitation. This study proposes to compare the agreement between experts and residents in orthopedics for treatment indication of proximal humerus fractures, utilizing 3D-models, holography (augmented reality), x-rays, and tomography as diagnostic methods. Methods Twenty orthopedists (ten experts in shoulder and elbow surgery and ten experts in traumatology) and thirty resident physicians in orthopedics evaluated nine fractures of the proximal humerus, randomly distributed as x-rays, tomography, 3D-models and holography, using the Neer and AO / OTA Classifications. After, we evaluated the interobserver agreement between treatment options (conservative, osteosynthesis and arthroplasty) and whether the experience of the evaluators interfered with the results. Results The interobserver agreement analysis showed the following kappa-values: κ = 0.362 and κ = 0.306 for experts and residents (3D-models); κ = 0.240 and κ = 0.221 (X-ray); κ = 0.233 and κ = 0.123 (Tomography) and κ = 0.321 and κ = 0.160 (Holography), for experts and residents respectively. Moreover, residents and specialists were discordant in the treatment indication using Tomography as a diagnostic method (p = 0.003). The same was not seen for the other diagnostic methods (p > 0.05). Conclusions Three-dimensional models showed, overall, the highest interobserver agreement (experts versus residents in orthopedics) for the choice of treatment of proximal humerus fractures compared to X-ray, Tomography, and Holography. Agreement in the choice of treatment among experts that used Tomography and Holography as diagnostic methods were two times higher compared to residents. Trial registration Registered in Brazil Platform under no. CAAE 12273519.7.0000.5505 .http://link.springer.com/article/10.1186/s13037-020-00258-2Three-dimensional models3D-modelsAugmented realityHolographyProximal humerus fractures |
| spellingShingle | Luiz Fernando Cocco André Yui Aihara Carlos Franciozi Fernando Baldy dos Reis Marcus Vinicius Malheiro Luzo Three-dimensional models increase the interobserver agreement for the treatment of proximal humerus fractures Patient Safety in Surgery Three-dimensional models 3D-models Augmented reality Holography Proximal humerus fractures |
| title | Three-dimensional models increase the interobserver agreement for the treatment of proximal humerus fractures |
| title_full | Three-dimensional models increase the interobserver agreement for the treatment of proximal humerus fractures |
| title_fullStr | Three-dimensional models increase the interobserver agreement for the treatment of proximal humerus fractures |
| title_full_unstemmed | Three-dimensional models increase the interobserver agreement for the treatment of proximal humerus fractures |
| title_short | Three-dimensional models increase the interobserver agreement for the treatment of proximal humerus fractures |
| title_sort | three dimensional models increase the interobserver agreement for the treatment of proximal humerus fractures |
| topic | Three-dimensional models 3D-models Augmented reality Holography Proximal humerus fractures |
| url | http://link.springer.com/article/10.1186/s13037-020-00258-2 |
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