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Interobserver agreement on MRI evaluation of patients with cervical radiculopathy

PainSci » bibliography » Kuijper et al 2011
Tags: diagnosis, neck, imaging, head/neck, spine

One article on PainSci cites Kuijper 2011: The Complete Guide to Neck Pain & Cricks

PainSci commentary on Kuijper 2011: ?This page is one of thousands in the bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.

This reliability study compared the diagnoses of two neuroradiologists who had only MRI results to work with. They looked at scans of only 82 patients with recent symptoms, and they mostly agreed on nerve root compressions (𝛋=.67–0.76) — which is “substantial,” but also probably less reliable than most ordinary people would expect. Each of them saw a few nerve root compressions that the other did not.

Reliability was lower for herniated discs (𝛋=.63) and spinal canal narrowing (𝛋=.63). Those aren’t terrible numbers for radiology, but they aren’t great either.

See also Kuijper.

~ Paul Ingraham

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

AIM: To evaluate the interobserver agreement on magnetic resonance imaging (MRI) evaluation of herniated discs, spondylotic neuroforaminal stenosis, and root compression in patients with recent onset cervical radiculopathy and in addition, to assess the added value of disclosure of clinical information to interobserver agreement.

MATERIALS AND METHODS: The MRI images of 82 patients with less than 1 month of symptoms and signs of cervical radiculopathy were evaluated independently by two neuroradiologists who were unaware of clinical findings. MRI analysis was repeated after disclosure of clinical information. Interobserver agreement was calculated using kappa statistics.

RESULTS: The kappa score for evaluation of herniated discs and of spondylotic foramen stenosis was 0.59 and 0.63, respectively. A kappa score of 0.67 was found for the presence of root compression. After disclosure of clinical information kappa scores increased slightly: from 0.59 to 0.62 for the detection of herniated discs, from 0.63 to 0.66 for spondylotic foramen stenosis, and from 0.67 to 0.76 for root compression.

CONCLUSION: Interobserver reliability of MRI evaluation in patients with cervical radiculopathy was substantial for root compression, with or without clinical information. Agreement on the cause of the compression, i.e., herniated disc or spondylotic foraminal stenosis, was lower.

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