British athletics muscle injury classification: a reliability study for a new grading system
This classification system is based on MRI parameters shown to have prognostic relevance.
It is simple to use, reproducible and clinically relevant which will enhance clinical practice.
Once clinicians are familiar with the classification inter & intrarater reliability will improve.
To implement and validate the newly proposed British athletics muscle injury classification in the assessment of hamstring injuries in track and field athletes and to analyse the nature and frequency of the discrepancies.
Materials and methods
This was a retrospective study analysing hamstring injuries in elite British athletes using the proposed classification system. Classification of 65 hamstring injuries in 45 high-level athletes by two radiologists at two time points 4 months apart to determine interrater variability, intrarater variability, and feasibility of the classification system was undertaken.
Interrater Kappa values of 0.80 (95% confidence interval [CI]: 0.67–0.92; p<0.0001) for Round 1 and 0.88 (95% CI: 0.76–1.00; p<0.0001) for Round 2 of the review were observed. Percentages of agreement were 85% for Round 1 and 91% for Round 2. The intrarater Kappa value for the two reviewers were 0.76 (95% CI: 0.63–0.88; p<0.0001) and 0.65 (95% CI: 0.53–0.76; p<0.0001) and the average was 0.71 suggesting substantial overall agreement. The percentages of agreement were 82% and 72%, respectively.
This classification system is straightforward to use and produces both reproducible and consistent results based on interrater and intrarater Kappa values with at least substantial agreement in all groups. Further work is ongoing to investigate whether individual grades within this classification system provide prognostic information and could guide clinical management.
Copyright © 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
Note to users: Corrected proofs are Articles in Press that contain the authors' corrections. Final citation details, e.g., volume and/or issue number, publication year and page numbers, still need to be added and the text might change before final publication.
Although corrected proofs do not have all bibliographic details available yet, they can already be cited using the year of online publication and the DOI , as follows: author(s), article title, Publication (year), DOI. Please consult the journal's reference style for the exact appearance of these elements, abbreviation of journal names and use of punctuation.
When the final article is assigned to volumes/issues of the Publication, the Article in Press version will be removed and the final version will appear in the associated published volumes/issues of the Publication. The date the article was first made available online will be carried over.
Autor / Fonte:A Patel, J Chakraverty, N Pollock, R Chakraverty, A K Suokas, S L James Clinical Radiology 2015 September 15