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Published on: July 26, 2024
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Improving Heckmatt muscle ultrasound grading scale through Rasch analysis
Juerd Wijntjes1, Christiaan Saris1, Jonne Doorduin1
1Department of Neurology, Clinical Neuromuscular Imaging Group, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, the Netherlands.
Neuromuscular Disorders : NMD
|July 26, 2024
Summary
The 4-point Heckmatt scale for muscle ultrasound analysis had inconsistent scoring in some muscles. A revised 3-point scale improved accuracy and usability for neuromuscular disorder diagnosis.
Area of Science:
- Neurology
- Medical Imaging
- Biostatistics
Background:
- The Heckmatt scale is a 4-point system for analyzing muscle ultrasound images.
- Its application is expanding across various muscles and neuromuscular disorders.
- Evaluating the measurement properties of the current Heckmatt scale is necessary.
Purpose of the Study:
- To investigate and improve the measurement properties of the Heckmatt scale.
- To assess observer consistency in using the 4 response categories.
- To determine if a modified scale enhances accuracy.
Main Methods:
- Retrospective observational study of muscle ultrasound images.
- Inclusion of images from 1783 patients undergoing ultrasound for clinical or research purposes.
- Application of Rasch analysis to evaluate the Heckmatt scale's measurement properties.
Main Results:
- Data comprised 30,967 muscle ultrasound images from 43 different muscles.
- Inconsistent use of 4 response categories was observed in 8 of 43 muscles, particularly bulbar muscles.
- Rescoring to a 3-point scale resulted in consistent category use across all 43 muscles.
Conclusions:
- A 3-point Heckmatt grading scale demonstrates improved accuracy and consistent observer use compared to the original 4-point scale.
- The 3-point scale simplifies usage and enhances applicability in clinical practice and research.
- This modification optimizes muscle ultrasound analysis for neuromuscular disorders.
