title: Interrater reliability of quantitative ultrasound using force feedback among examiners with varied levels of experience.
abstract: Background. Quantitative ultrasound measures are influenced by multiple external factors including examiner scanning force. Force feedback may foster the acquisition of reliable morphometry measures under a variety of scanning conditions. The purpose of this study was to determine the reliability of force-feedback image acquisition and morphometry over a range of examiner-generated forces using a muscle tissue-mimicking ultrasound phantom. Methods. Sixty material thickness measures were acquired from a muscle tissue mimicking phantom using B-mode ultrasound scanning by six examiners with varied experience levels (i.e., experienced, intermediate, and novice). Estimates of interrater reliability and measurement error with force feedback scanning were determined for the examiners. In addition, criterion-based reliability was determined using material deformation values across a range of examiner scanning forces (1-10 Newtons) via automated and manually acquired image capture methods using force feedback. Results. All examiners demonstrated acceptable interrater reliability (intraclass correlation coefficient, ICC = .98, p < .001) for material thickness measures obtained using force feedback. Individual examiners exhibited acceptable reliability with the criterion-based reference measures (ICC > .90, p < .001), independent of their level of experience. The measurement error among all examiners was 1.5%-2.9% across all applied stress conditions. Conclusion. Manual image capture with force feedback may aid the reliability of morphometry measures across a range of examiner scanning forces, and allow for consistent performance among examiners with differing levels of experience.
authors.affiliation: Muscle Morphology, Mechanics and Performance Laboratory, Clinical Research Center, Veterans Affairs Medical Center, Washington, D.C., United States; Geriatrics and Extended Care Service, Veterans Affairs Medical Center, Washington, D.C., United States; Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, D.C., United States.
authors.forename: Michael O
authors.initials: MO
authors.lastname: Harris-Love
authors.affiliation: Muscle Morphology, Mechanics and Performance Laboratory, Clinical Research Center, Veterans Affairs Medical Center, Washington, D.C., United States; Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, D.C., United States.
authors.forename: Catheeja
authors.initials: C
authors.lastname: Ismail
authors.affiliation: Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital , Washington , D.C. , United States.
authors.forename: Reza
authors.initials: R
authors.lastname: Monfaredi
authors.affiliation: Muscle Morphology, Mechanics and Performance Laboratory, Clinical Research Center, Veterans Affairs Medical Center , Washington , D.C. , United States.
authors.forename: Haniel J
authors.initials: HJ
authors.lastname: Hernandez
authors.affiliation: Muscle Morphology, Mechanics and Performance Laboratory, Clinical Research Center, Veterans Affairs Medical Center , Washington , D.C. , United States.
authors.forename: Donte
authors.initials: D
authors.lastname: Pennington
authors.affiliation: Muscle Morphology, Mechanics and Performance Laboratory, Clinical Research Center, Veterans Affairs Medical Center, Washington, D.C., United States; Health Sciences Division, Howard Community College, Columbia, MD, United States.
authors.forename: Paula
authors.initials: P
authors.lastname: Woletz
authors.affiliation: Muscle Morphology, Mechanics and Performance Laboratory, Clinical Research Center, Veterans Affairs Medical Center, Washington, D.C., United States; Research Service, Veterans Affairs Medical Center, Washington, D.C., United States.
authors.forename: Valerie
authors.initials: V
authors.lastname: McIntosh
authors.affiliation: Muscle Morphology, Mechanics and Performance Laboratory, Clinical Research Center, Veterans Affairs Medical Center, Washington, D.C., United States; Research Service, Veterans Affairs Medical Center, Washington, D.C., United States.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Adams
authors.affiliation: Research Service, Veterans Affairs Medical Center, Washington, D.C., United States; Departments of Medicine, Biochemistry & Molecular Medicine, School of Medicine and Health Sciences, George Washington University, Washington, D.C., United States; Departments of Medicine and Rehabilitation Medicine, School of Medicine, Georgetown University, Washington, D.C., United States.
authors.forename: Marc R
authors.initials: MR
authors.lastname: Blackman
keywords: Diagnostic imaging; Morphometry; Quantitative ultrasound; Reliability; Robotics; Sensorimotor feedback