Identification of fractures on pediatric foot radiographs: do localization cues improve diagnostic accuracy and reduce interpretation time?
Skeletal Radiol
; 53(2): 345-352, 2024 Feb.
Article
en En
| MEDLINE
| ID: mdl-37490103
ABSTRACT
OBJECTIVE:
To investigate the diagnostic accuracy and time in the detection of fractures on pediatric foot radiographs marked without and with localization cues.METHOD:
One-hundred randomly selected foot radiographic examinations that were performed on children (<18 years old) after injury and with at least 4 weeks of follow-up were included. Blinded to history and diagnosis, 4 readers (one each medical student, pediatrician, pediatric orthopedic surgeon, and pediatric musculoskeletal radiologist) retrospectively and independently reviewed each examination twice (without and with cue, at least 1 month apart, and after randomization). Each reader recorded the presence or absence of a fracture, fracture location, diagnostic confidence, and the total (interpretation) time spent on each study. Diagnostic accuracy, reader confidence, and interpretation time were compared between examinations without and with cues.RESULTS:
Our study included 59 examinations without and 41 with fractures (21 phalangeal, 18 metatarsal, and 2 tarsal fractures). Localization cues improved inter-reader agreement (κ=0.36 to 0.64), overall sensitivity (68 to 72%), specificity (66 to 73%), and diagnostic accuracy (67 to 73%); thus, overcalled and missed rates also improved from 34 to 27% and 32 to 28%, respectively. Reader confidence improved with cue (49 to 61%, p<0.01) with higher incremental improvement with younger children (30% for 1-6 years; 14% for 7-11 years; and 10% for 12-17 years). Interpretation time decreased by 40% per examination (40±22 s without to 24±13 s with cues, p<0.001).CONCLUSION:
Localization cues improved diagnostic accuracy and reader confidence, reducing interpretation time in the detection of pediatric foot fractures.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Traumatismos de los Pies
/
Fracturas Óseas
Tipo de estudio:
Clinical_trials
/
Diagnostic_studies
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Prognostic_studies
Límite:
Adolescent
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Child
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Humans
Idioma:
En
Año:
2024
Tipo del documento:
Article