title: Does clinical experience affect the reproducibility of cervical vertebrae maturation method?
abstract: OBJECTIVE
  To assess interobserver and intraobserver reproducibility of the cervical vertebrae maturation method (CVMM) among three panels of judges with different levels of orthodontic experience (OE).
  
  
  METHODS
  Fifty individual lateral cephalograms of good quality with complete visualization of cervical vertebrae 1 to 4 were selected. Thirty clinicians, divided according to their OE into three groups (junior group, JU, OE ≤ 1 year; postgraduate group, PG, 2 ≤ OE ≤ 4 years; specialist group, SP, OE ≥ 7 years), evaluated the cephalograms in two sessions (T1 and T2) at 3 weeks apart. Kendall's W and weighted Cohen's kappa (κ) coefficients were performed to assess interobserver and intraobserver agreement. The level of significance was set as P < .05. For both the interobserver and the intraobserver datasets, the percentage of perfect agreement (PPA) and the number of stages apart for each disagreement were calculated.
  
  
  RESULTS
  Kendall's W at T1 was SP  =  0.61, PG  =  0.70, and JU  =  0.87; at T2 it was SP  =  0.78, PG  =  0.85, and JU  =  0.86. The percentage of total interobserver perfect agreement (Inter-PPA) was 42.3% at T1 and 46.3% at T2. The JU group had the highest Cohen's κ coefficient at 0.78, while the PG and SP had coefficients of 0.64 each. The percentage of total intraobserver perfect agreement (Intra-PPA) was 54.2%.
  
  
  CONCLUSIONS
  The reproducibility of the method was not improved by the level of orthodontic experience. The group with the lowest level of orthodontic experience had the best performance.
authors.affiliation: a   Postdoctoral student, School of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Napes, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Rongo
authors.affiliation: b   Associate Professor, School of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Naples, Italy.
authors.forename: Rosa
authors.initials: R
authors.lastname: Valleta
authors.affiliation: c   PhD student, School of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Naples, Italy.
authors.forename: Rosaria
authors.initials: R
authors.lastname: Bucci
authors.affiliation: d   Assistant Professor, Department of Orthodontics, University of Bologna, Bologna, Italy.
authors.forename: Giulio Alessandri
authors.initials: GA
authors.lastname: Bonetti
authors.affiliation: e   Professor and Chair, School of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Naples, Italy.
authors.forename: Ambrosina
authors.initials: A
authors.lastname: Michelotti
authors.affiliation: f   Research Fellow, School of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Naples, Italy; Division of Dentistry, Department of Pediatric Surgery, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: D'Antò
mesh_terms: D000365:Age Determination by Skeleton / Q000379:methods*; D002508:Cephalometry / Q000379:methods*; D002574:Cervical Vertebrae / Q000033:anatomy & histology* / Q000254:growth & development; D006801:Humans; D015588:Observer Variation; D015203:Reproducibility of Results
keywords: Cervical vertebrae maturation method; Reliability; Reproducibility; Skeletal maturation