The intra‐ and inter‐rater reliability of plain radiographs for Hill–Sachs and bony glenoid lesions: evaluation of the radiographic portion of the instability severity index score. Issue 1 (8th September 2012)

• Record Type: Journal Article
• Authors: Bouliane, Martin J.; Chan, Holman; Kemp, Kyle; Glasgow, Robert; Lambert, Robert; Beaupre, Lauren A.; Sheps, David M.
• Is Part Of: Shoulder & elbow. Volume 5:Issue 1(2013:Jan.)
• Page Start: 33
• Page End: 38
• Publication Date: 2012-09-08
• Subjects: Elbow -- Diseases -- Periodicals; Elbow -- Surgery -- Periodicals; Shoulder -- Diseases -- Periodicals; Shoulder -- Surgery -- Periodicals; Shoulder -- Periodicals; Elbow -- Periodicals; Shoulder Joint -- Periodicals; Elbow Joint -- Periodicals; 617.572005
• DOI: 10.1111/j.1758-5740.2012.00208.x
• Languages: English
• ISSNs: 1758-5732

Abstract

<abstract abstract-type="main" xml:lang="en"> <title> <x xml:space="preserve">Abstract</x> </title> <p> <bold> <italic>Background</italic> </bold> The Instability Severity Index Score (ISIS) was developed to help determine the prognosis for recurrent shoulder instability and to assist surgical decision‐making. The radiographic portion of the ISIS represents a substantial portion of the total score. The present study examined the intra‐ and inter‐rater agreement, reliability and accuracy of the radiographic components of the ISIS.</p> <p> <bold> <italic>Methods</italic> </bold> Four assessors evaluated 49 blinded shoulder radiographs. Assessors documented their observation of the presence of a Hill–Sachs lesion and/or a loss of glenoid contour. Radiographs were reviewed twice in random order over two sessions. Intra‐ and inter‐rater reliability and accuracy were calculated.</p> <p> <bold> <italic>Results</italic> </bold> Intra‐rater agreement ranged from 71% to 94% for the presence of a Hill–Sachs lesion and 85% to 94% for a loss of glenoid contour. Intra‐rater kappa values ranged from 0.41 to 0.86 and 0.56 to 0.74, respectively. Inter‐rater agreement was found to be 63% to 78% and 78% to 90% for Hill–Sachs and glenoid lesions, respectively. Corresponding kappa values were 0.31 and 0.48. Accuracy ranged from 29% to 57% for Hill–Sachs and 65% to 73% for glenoid lesions.</p> <p> <bold> <italic>Conclusions</italic> </bold> In the present study, intra‐ and inter‐rater reliability of the radiographic portion of the ISIS demonstrated limited kappa and accuracy. We suggest that the ISIS should be used with caution as a guide for surgical management.</p> </abstract>