From: Reliability of measurements of the fractured clavicle: a systematic review
Author | Number of patients | Goal of study | Modality | Measurements | Observers (role)/occasions | Statistics | Conclusion |
---|---|---|---|---|---|---|---|
Jones (2014) 18 | 30 | Reliability Shortening in mm Displacement in % Comminuted Y/N Surgery Y/N | X-ray AP 30° caudo-cranial | Calibrated measuring tool | 13 (13 surgeons) 2 (after 4 months) | Power analysis + intraobserver shortening 0.38 Interobserver shortening 0.33 K values stated | Strong inter- and intraobserver agreement for displacement and comminution |
Weak to no interobserver and minimal intraobserver agreement for shortening | |||||||
Silva (2013) 19 | 32 | Interobserver and intraobserver reliability shortening in MSCF in adolescents (9–18) | X-ray 15° caudo-cranial AP | 1. Observers’ method of choice | 7 (3 pediatric orthopedic surgeons, 1 pediatric orthopedic fellow, 2 orthopedic residents, 1 medical student) 2 (1 week) | 1. Interrater reliability 0.771 and 0.743 Intrarater reliability 2.62 | Standardized method of measuring not better than method of choice |
2. Standardized method Digital measurement system | 2. Interrater reliability 0.741 and 0.685 Intrarater reliability 3.34 | Interrater no significant difference | |||||
Intrarater significant difference | |||||||
Smekal (2008) 20 | 30 | Assess different measuring methods and determine the most accurate method compared to CT | X-ray PA thorax 15° caudo-cranial AP of both clavicles 15° caudo-cranial AP clavicle CT | Standardized methods as described in article | 4 (3 orthopedic surgeons, 1 radiologist) 2 (after 1 month) | Determination of differences of mean values: paired t test or nonparametric Wilcoxon signed-rank test | Differences among measurements on X-ray and CT not significant Repeatability coefficient on AP 15 Clavicle and clinical measurement low |
Distribution from: Kolmogorov-Smirnov test | Also smallest agreement with CT | ||||||
Repeatability: RC according to Bland-Altman A p < 0.05 | PA thorax to determine length differences | ||||||
Archer (2016) 21 | 22 | Identify correlation between plain film and computed tomography (CT) measurement of displacement and the inter- and intraobserver reliability of repeated radiographic measurements | X-ray AP plain film CT | No standardized method of measurement | 6 (3 orthopedic surgeons 3 residents) | Correlation using the Bland-Altman reliability coefficient Limits of agreement using the standard deviation (SD): 3.48 reliability using the Cronbach α coefficient. 0.90 Intraobserver reliability using paired t tests for each observer: all but one > 0.05 | Plain film measurements of acute MSCF do not reliably predict shortening |