Determining the reliability of the Graf classification for hip dysplasia

Clinical Orthopaedics and Related Research
Andreas RoposchJames G Wright

Abstract

We sought to establish the levels of interrater reliability and intrarater reliability of the Graf classification among orthopaedic surgeons in their final training year and who learned the method by instructed teaching or self study. Using standard teaching material developed by Graf, two groups of senior orthopaedic residents at the same training level received structured teaching sessions (Group A, n = 2) or performed self study (Group B, n = 2). Interrater reliability and intrarater reliability were determined (Cohen's weighted kappa). Proportions of correctly rated sonograms were compared between groups, implications of misclassifications were analyzed, and sensitivity analyses were performed. Interrater reliability was 0.59 (95% CI = 0.32-0.85) for Group A, and 0.47 (95% CI = 0.14-0.79) for Group B. Intrarater reliability showed an overall kappa of 0.57 (95% CI = 0.35-0.78) in Group A, and 0.47 (95% CI = 0.19-0.75) in Group B. The proportion of correctly rated sonograms between groups was similar in the original dataset and in the sensitivity analysis. Misclassifications influencing treatment were infrequent; one patient would have received unwarranted treatment and three patients would not have received warranted treatme...Continue Reading

References

Mar 1, 1992·The Journal of Bone and Joint Surgery. British Volume·J G Wright, A R Feinstein
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Aug 12, 2005·The American Journal of Sports Medicine·Robert G MarxUNKNOWN Multicenter Orthopaedic Outcomes Network

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Citations

Sep 1, 2007·Journal of Children's Orthopaedics·Freih Odeh Abu Hassan, Akram Shannak
Nov 22, 2014·AJR. American Journal of Roentgenology·Vanessa Starr, Bo Yoon Ha
Jan 1, 2011·ISRN Orthopedics·Randall T Loder, Elaine N Skopelja
Dec 30, 2014·AJR. American Journal of Roentgenology·Elizabeth Ashby, Andreas Roposch
Sep 29, 2011·Clinical Orthopaedics and Related Research·Andreas RoposchJohn H Wedge
May 22, 2008·Der Orthopäde·M Nelitz, H Reichel
Sep 6, 2013·International Orthopaedics·Dahang ZhaoLuan Li
Sep 11, 2019·Journal of Pediatric Orthopedics. Part B·Luisella PedrottiMario Mosconi
Feb 11, 2014·Journal of Children's Orthopaedics·Hakan Omeroğlu
Aug 21, 2012·Clinical Orthopaedics and Related Research·Andreas RoposchGeorg Riedl
May 7, 2016·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Fuat BilgiliAtilla Sancar Parmaksızoğlu
Mar 16, 2016·Clinical Orthopaedics and Related Research·Eduardo N NovaisMariana L Meyers
Nov 4, 2014·JBJS Reviews·Julie Balch SamoraRobert H Quinn
Sep 23, 2014·The Journal of Pediatrics·Andreas RoposchMario Cortina-Borja

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