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Computer Tool Improves Spine X-Ray Interpretation

Interobserver agreement improved with use of computer-based methods to read flexion-extention spine X-rays

FRIDAY, Dec. 7 (HealthDay News) -- Standard techniques for interpreting flexion-extension X-rays of the spine may be unreliable in characterizing spine stability, but use of computer-assisted methods dramatically improves agreement among physicians reading these X-rays, according to a report published in the Spine Journal in December.

Mehul Taylor, M.D., of Baylor College of Medicine in Houston, and colleagues compared interobserver agreement of seven physicians familiar with reading spine X-rays in evaluating 75 flexion-extension X-rays of the cervical spine with and without computer-assisted technology.

Rates of agreement were low when physicians interpreted the X-rays using routine clinical methods (kappa = 0.17). However, when the physicians reassessed the X-rays a month later using validated computer-assisted methods, interobserver agreement improved (kappa = 0.77). Disagreements when computer-assisted interpretation was used included cases of severe degeneration or static misalignment but normal motion, or in fusion cases with 1.0 to 1.5 degrees of motion at the fusion site.

"This study suggests that commonly used methods to assess flexion-extension X-rays of the cervical spine may not provide reliable clinical information about intervertebral motion abnormalities, and that validated, computer-assisted methods can dramatically improve agreement among clinicians," the authors conclude.

The study was supported by a grant to Medical Metrics, Inc.

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