A comparison between orthopedic surgeon and allied health worker in pirani score
Syed Ali Anwer Jillani1, Muhammad Zeeshan Aslam1, Muhammad Amin Chinoy1
1The Indus Hospital, Karachi.
Insights
The Pirani Scoring method shows moderate to substantial agreement between orthopaedic surgeons and allied health workers for clubfoot assessment. Plaster technicians can reliably use this tool after initial training and supervision.
Area of Science:
- Orthopaedics
- Paediatric Orthopaedics
- Medical Device Evaluation
Background:
- Clubfoot is a common congenital foot deformity requiring accurate assessment for effective treatment.
- The Pirani Scoring system is a widely used tool for evaluating clubfoot severity.
- Assessing inter-observer reliability is crucial for standardizing clinical assessments.
Purpose of the Study:
- To evaluate the agreement between an orthopaedic surgeon and an allied health worker (plaster technician) using the Pirani Scoring method for clubfoot.
- To determine the reliability of the Pirani Scoring system when used by non-physician healthcare professionals.
Main Methods:
- A descriptive cross-sectional study involving 57 children (92 feet) with untreated clubfoot.
- Independent scoring of clubfeet using the Pirani method by an orthopaedic surgeon and a trained plaster technician.
- Statistical analysis using SPSS 21 to assess inter-observer reliability.
Main Results:
- High agreement was observed between the surgeon and technician across most Pirani assessment categories.
- The difference in mean scores for hind foot and total scores was minimal (<0.09).
- Inter-observer reliability was substantial to moderate for most components, with fair agreement for Equinus Rigidity and Total Score.
Conclusions:
- The Pirani Scoring method is a reliable tool for clubfoot assessment by trained plaster technicians.
- Independent assessment by allied health workers is feasible with appropriate training and supervision.
- Standardized training is essential for consistent application of the Pirani Scoring system.
Objective:
To assess the strength of agreement for each of the Pirani assessment categories between an orthopaedic surgeon and allied health worker on scoring clubfeet.
Methods:
The descriptive cross-sectional study was conducted at the Indus Hospital, Karachi, from November 2012 to June 2013, comprised children below 12 months of age with untreated unilateral or bilateral clubfoot deformity an allied health worker, who was a plaster technician, was given 1-week training in the Pirani Scoring method. The feet were scored by the surgeon and the paramedic independently. SPSS 21 was used for statistical analysis.
Results:
The study had 57 patients, and 92 feet were assessed. The difference between the means of score of each parameter, including the hind foot score and total score, was less than 0.09. The means of total score were found to be identical. Total Hind Foot Score was 0.48 and Total Score was 0.354. The statistical inter-observer reliability for all components was rated as substantial to moderate agreement except Equinus Rigidityand Total Score, which showed fair agreement.
Conclusions:
Pirani scoring method for clubfoot assessment was found to be a reliable tool for use by plaster technicians for independent assessment of clubfoot. However, prior training and supervision in the early phase is necessary.
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