Original articleReliability of a standardized protocol to calculate cross-sectional chest area and severity indices to evaluate pectus excavatum
Section snippets
Subjects
All participants in the multicenter study signed an informed consent that was in compliance with the human experimental guidelines of the United States Department of Health and Human Services and of the Eastern Virginia Medical School Institutional Investigation Review Board. The 32 participants were predominately male (91%), and the average age was 13.2 years (range, 6.1-19.7 years). Because of the timing of this reliability study early in the multicenter study, all 32 patients were from the
Results
The protocol used by the radiologists included detailed instructions on how to select the appropriate 5 images (see Methods). Each of the 32 scans had up to 6 pages of images that could be selected for calculation of pectus defect severity. Reliability between the 2 radiologists was entirely dependent on the images chosen and the impact of any differences in the images on the raw measurements. The 2 radiologists chose within 1 image of each other most of the time (81%; n = 160) and were within
Discussion
The 5-position standard protocol was proposed to alleviate potential biases and inconsistencies in data being collected from multiple centers with competing surgical treatments. Although the protocol is more extensive than just determining a single Haller index as a rough gauge of severity, it provides a tool for assessing both the need for surgery and the outcome of repair in any future quality monitoring program or to readily study any potential future modifications of surgical technique. To
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