REPRODUCIBILITY OF MODIFIED WALDENSTRÖM CLASSIFICATION IN PERTHES DISEASE.

Area of Science:

• Orthopedics
• Radiology
• Pediatric Medicine

Background:

• Legg-Calvé-Perthes disease requires accurate classification for treatment planning.
• The modified Waldenström classification is used for assessing disease severity and progression.
• Reliability of classification systems is crucial for consistent clinical decision-making.

Purpose of the Study:

• To evaluate the intraobserver and interobserver reliability of the modified Waldenström classification system for Legg-Calvé-Perthes disease.
• To assess how professional expertise influences the reliability of this classification system.

Main Methods:

• Twelve evaluators (pediatric orthopedists, radiologists, resident physicians) assessed 40 pairs of pelvic radiographs.
• Radiographs were re-evaluated by the same evaluators after two weeks.
• Kappa and Kendall's W indexes were used to measure intraobserver and interobserver reliability.

Main Results:

• Average intraobserver agreement (Kappa) was 0.394, indicating reasonable agreement.
• Interobserver agreement (Kappa) was 0.243 and 0.245 in the two evaluations, indicating reasonable agreement.
• Kendall's W values showed higher concordance among pediatric orthopedists (0.686) compared to radiologists (0.630) and resident physicians (0.529).

Conclusions:

• The modified Waldenström classification demonstrates moderate intraobserver and reasonable interobserver agreement.
• The level of agreement is influenced by the evaluator's experience and area of expertise.
• Further refinement or training may be needed to enhance interobserver consistency.