title: Legg-Calvé-Perthes: interobserver and intraobserver reliability of the modified Herring lateral pillar classification.
abstract: BACKGROUND
  The purpose of our study was to independently assess the reliability of the modified Herring lateral pillar classification.
  
  
  METHODS
  Thirty-five standardized true anteroposterior radiographs of children in the fragmentation phase were independently assessed by 6 senior observers on 2 separate occasions (6 wk apart). The κ analysis was used to assess the interobserver and intraobserver agreement.
  
  
  RESULTS
  Intraobserver analysis revealed at best only moderate agreement for 2 observers. Three observers showed fair consistency, whereas 1 remaining observer showed poor consistency between repeated observations (P < 0.01). The highest scores for interobserver agreement varying between moderate to good could only be established between 2 observers. For the remaining observers results were just fair (P < 0.01).
  
  
  CONCLUSIONS
  This study highlights the lack of agreement between senior clinicians when applying the modified lateral pillar classification. The results from the Herring group were significantly better than ours, but utilized a weighted κ for analysis, which may have given artificially high scores. To our knowledge, this is the first time the modified lateral pillar classification has been independently tested for its reproducibility by a specialist pediatric orthopaedic unit.
authors: Royal Derby Hospital, Derby, UK.
authors: Rohan
authors: R
authors: Rajan
authors: Jeevan
authors: J
authors: Chandrasenan
authors: Kathryn
authors: K
authors: Price
authors: Chrompolis
authors: C
authors: Konstantoulakis
authors: James
authors: J
authors: Metcalfe
authors: Stanley
authors: S
authors: Jones
mesh_terms: D002648:Child; D006801:Humans; D007873:Legg-Calve-Perthes Disease / Q000145:classification* / Q000000981:diagnostic imaging / Q000473:pathology; D015588:Observer Variation; D011859:Radiography; D015203:Reproducibility of Results