Classifying radiographic changes of the pubic symphysis in male athletes: Development and reproducibility of a new scoring protocol

<h3>Purpose</h3><p dir="ltr">To develop a specified radiographic scoring system for the pubic symphysis and adjacent bones, and to examine the intra- and inter-rater reproducibility of this system.</p><h3>Method</h3><p dir="ltr">Developme...

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Main Author: Andreas Serner (8377587) (author)
Other Authors: Javier Arnaiz (11026980) (author), Andrea Mosler (9581147) (author), Emad Almusa (17052432) (author), Zarko Vuckovic (17052435) (author), Igor Tak (7015109) (author), Mario Maas (3400763) (author), Adam Weir (8377590) (author), Per Hölmich (5585114) (author)
Published: 2020
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_version_ 1864513559482859520
author Andreas Serner (8377587)
author2 Javier Arnaiz (11026980)
Andrea Mosler (9581147)
Emad Almusa (17052432)
Zarko Vuckovic (17052435)
Igor Tak (7015109)
Mario Maas (3400763)
Adam Weir (8377590)
Per Hölmich (5585114)
author2_role author
author
author
author
author
author
author
author
author_facet Andreas Serner (8377587)
Javier Arnaiz (11026980)
Andrea Mosler (9581147)
Emad Almusa (17052432)
Zarko Vuckovic (17052435)
Igor Tak (7015109)
Mario Maas (3400763)
Adam Weir (8377590)
Per Hölmich (5585114)
author_role author
dc.creator.none.fl_str_mv Andreas Serner (8377587)
Javier Arnaiz (11026980)
Andrea Mosler (9581147)
Emad Almusa (17052432)
Zarko Vuckovic (17052435)
Igor Tak (7015109)
Mario Maas (3400763)
Adam Weir (8377590)
Per Hölmich (5585114)
dc.date.none.fl_str_mv 2020-11-28T00:00:00Z
dc.identifier.none.fl_str_mv 10.1016/j.ejrad.2020.109452
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Classifying_radiographic_changes_of_the_pubic_symphysis_in_male_athletes_Development_and_reproducibility_of_a_new_scoring_protocol/24204198
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Clinical sciences
Reliability
X-ray
Pubic symphysis
Pelvis
Groin pain
Sport
dc.title.none.fl_str_mv Classifying radiographic changes of the pubic symphysis in male athletes: Development and reproducibility of a new scoring protocol
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <h3>Purpose</h3><p dir="ltr">To develop a specified radiographic scoring system for the pubic symphysis and adjacent bones, and to examine the intra- and inter-rater reproducibility of this system.</p><h3>Method</h3><p dir="ltr">Development of the scoring protocol was performed in three stages using AP pelvis radiographs of 102 male adult athletes. The final protocol included 5 overall scoring items, which included further specification of locations: 1) bone lucency (erosion-like configuration and cysts), 2) proliferation, 3) fragmentation, 4) sclerosis, and 5) joint space width. Intra- and inter-rater reproducibility were determined using Cohen’s kappa statistic (κ) and intraclass correlation coefficient (ICC). The standard error of measurement (SEM) and minimal detectable difference (MDD) were also determined.</p><h3>Results</h3><p dir="ltr">We present a radiographic scoring protocol with clear definitions and examples to improve clinical usability. Intra-rater reproducibility was: bone lucency (erosion-like configuration or cysts): κ = 0.67 (95 %CI 0.56−0.78), proliferation: κ = 0.54 (95 %CI 0.38−0.70), fragmentation: κ = 0.80 (95 %CI 0.67−0.93), sclerosis: κ = 0.60 (95 %CI 0.49−0.71), and joint space width: ICC(2.1) 0.85 (95 %CI 0.78−0.89), SEM 0.4 mm, MDD 1.2 mm. Inter-rater reproducibility was: bone lucency: κ = 0.61 (95 %CI 0.50−0.72), proliferation: κ = 0.34 (95 %CI 0.20−0.48), fragmentation: κ = 0.67 (95 %CI 0.50−0.84), sclerosis: κ = 0.30 (95 %CI 0.17−0.43), and joint space width: ICC(2.1) 0.72 (95 %CI 0.59−0.81), SEM 0.5 mm., MDD 1.5 mm.</p><h3>Conclusions</h3><p dir="ltr">The Aspetar pubic symphysis radiographic scoring protocol contains five overall scoring items, with additional specifications. These five items showed moderate to almost perfect intra-rater reproducibility, and fair to substantial inter-rater reproducibility. This protocol provides the basis for use in clinical practice, and will allow future investigations of the clinical significance of radiographic changes at the pubic symphysis in athletes.</p><h2>Other Information</h2><p dir="ltr">Published in: European Journal of Radiology<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.ejrad.2020.109452" target="_blank">https://dx.doi.org/10.1016/j.ejrad.2020.109452</a></p>
eu_rights_str_mv openAccess
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identifier_str_mv 10.1016/j.ejrad.2020.109452
network_acronym_str Manara2
network_name_str Manara2
oai_identifier_str oai:figshare.com:article/24204198
publishDate 2020
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rights_invalid_str_mv CC BY 4.0
spelling Classifying radiographic changes of the pubic symphysis in male athletes: Development and reproducibility of a new scoring protocolAndreas Serner (8377587)Javier Arnaiz (11026980)Andrea Mosler (9581147)Emad Almusa (17052432)Zarko Vuckovic (17052435)Igor Tak (7015109)Mario Maas (3400763)Adam Weir (8377590)Per Hölmich (5585114)Biomedical and clinical sciencesClinical sciencesReliabilityX-rayPubic symphysisPelvisGroin painSport<h3>Purpose</h3><p dir="ltr">To develop a specified radiographic scoring system for the pubic symphysis and adjacent bones, and to examine the intra- and inter-rater reproducibility of this system.</p><h3>Method</h3><p dir="ltr">Development of the scoring protocol was performed in three stages using AP pelvis radiographs of 102 male adult athletes. The final protocol included 5 overall scoring items, which included further specification of locations: 1) bone lucency (erosion-like configuration and cysts), 2) proliferation, 3) fragmentation, 4) sclerosis, and 5) joint space width. Intra- and inter-rater reproducibility were determined using Cohen’s kappa statistic (κ) and intraclass correlation coefficient (ICC). The standard error of measurement (SEM) and minimal detectable difference (MDD) were also determined.</p><h3>Results</h3><p dir="ltr">We present a radiographic scoring protocol with clear definitions and examples to improve clinical usability. Intra-rater reproducibility was: bone lucency (erosion-like configuration or cysts): κ = 0.67 (95 %CI 0.56−0.78), proliferation: κ = 0.54 (95 %CI 0.38−0.70), fragmentation: κ = 0.80 (95 %CI 0.67−0.93), sclerosis: κ = 0.60 (95 %CI 0.49−0.71), and joint space width: ICC(2.1) 0.85 (95 %CI 0.78−0.89), SEM 0.4 mm, MDD 1.2 mm. Inter-rater reproducibility was: bone lucency: κ = 0.61 (95 %CI 0.50−0.72), proliferation: κ = 0.34 (95 %CI 0.20−0.48), fragmentation: κ = 0.67 (95 %CI 0.50−0.84), sclerosis: κ = 0.30 (95 %CI 0.17−0.43), and joint space width: ICC(2.1) 0.72 (95 %CI 0.59−0.81), SEM 0.5 mm., MDD 1.5 mm.</p><h3>Conclusions</h3><p dir="ltr">The Aspetar pubic symphysis radiographic scoring protocol contains five overall scoring items, with additional specifications. These five items showed moderate to almost perfect intra-rater reproducibility, and fair to substantial inter-rater reproducibility. This protocol provides the basis for use in clinical practice, and will allow future investigations of the clinical significance of radiographic changes at the pubic symphysis in athletes.</p><h2>Other Information</h2><p dir="ltr">Published in: European Journal of Radiology<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.ejrad.2020.109452" target="_blank">https://dx.doi.org/10.1016/j.ejrad.2020.109452</a></p>2020-11-28T00:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1016/j.ejrad.2020.109452https://figshare.com/articles/journal_contribution/Classifying_radiographic_changes_of_the_pubic_symphysis_in_male_athletes_Development_and_reproducibility_of_a_new_scoring_protocol/24204198CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/242041982020-11-28T00:00:00Z
spellingShingle Classifying radiographic changes of the pubic symphysis in male athletes: Development and reproducibility of a new scoring protocol
Andreas Serner (8377587)
Biomedical and clinical sciences
Clinical sciences
Reliability
X-ray
Pubic symphysis
Pelvis
Groin pain
Sport
status_str publishedVersion
title Classifying radiographic changes of the pubic symphysis in male athletes: Development and reproducibility of a new scoring protocol
title_full Classifying radiographic changes of the pubic symphysis in male athletes: Development and reproducibility of a new scoring protocol
title_fullStr Classifying radiographic changes of the pubic symphysis in male athletes: Development and reproducibility of a new scoring protocol
title_full_unstemmed Classifying radiographic changes of the pubic symphysis in male athletes: Development and reproducibility of a new scoring protocol
title_short Classifying radiographic changes of the pubic symphysis in male athletes: Development and reproducibility of a new scoring protocol
title_sort Classifying radiographic changes of the pubic symphysis in male athletes: Development and reproducibility of a new scoring protocol
topic Biomedical and clinical sciences
Clinical sciences
Reliability
X-ray
Pubic symphysis
Pelvis
Groin pain
Sport