title: Online Studies on Variation in Orthopedic Surgery: Computed Tomography in MPEG4 Versus DICOM Format.
abstract: The purpose of this study was to compare the observer participation and satisfaction as well as interobserver reliability between two online platforms, Science of Variation Group (SOVG) and Traumaplatform Study Collaborative, for the evaluation of complex tibial plateau fractures using computed tomography in MPEG4 and DICOM format. A total of 143 observers started with the online evaluation of 15 complex tibial plateau fractures via either the SOVG or Traumaplatform Study Collaborative websites using MPEG4 videos or a DICOM viewer, respectively. Observers were asked to indicate the absence or presence of four tibial plateau fracture characteristics and to rate their satisfaction with the evaluation as provided by the respective online platforms. The observer participation rate was significantly higher in the SOVG (MPEG4 video) group compared to that in the Traumaplatform Study Collaborative (DICOM viewer) group (75 and 43%, respectively; P < 0.001). The median observer satisfaction with the online evaluation was seven (range, 0-10) using MPEG4 video compared to six (range, 1-9) using DICOM viewer (P = 0.11). The interobserver reliability for recognition of fracture characteristics in complex tibial plateau fractures was higher for the evaluation using MPEG4 video. In conclusion, observer participation and interobserver reliability for the characterization of tibial plateau fractures was greater with MPEG4 videos than with a standard DICOM viewer, while there was no difference in observer satisfaction. Future reliability studies should account for the method of delivering images.
authors.affiliation: Hand and Upper Extremity Service, Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA, 02114, USA. josjmellema@gmail.com.
authors.forename: Jos J
authors.initials: JJ
authors.lastname: Mellema
authors.affiliation: Department of Orthopedic Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1100 DD, Amsterdam, The Netherlands.
authors.forename: Wouter H
authors.initials: WH
authors.lastname: Mallee
authors.affiliation: Department of Orthopedic Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1100 DD, Amsterdam, The Netherlands.
authors.forename: Thierry G
authors.initials: TG
authors.lastname: Guitton
authors.affiliation: Department of Orthopedic Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1100 DD, Amsterdam, The Netherlands.
authors.forename: C Niek
authors.initials: CN
authors.lastname: van Dijk
authors.affiliation: Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, 1400 Barbara Jordan Blvd. Suite 2.834; MC: R1800, Austin, TX, 78723, USA.
authors.forename: David
authors.initials: D
authors.lastname: Ring
authors.affiliation: Department of Orthopedic Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1100 DD, Amsterdam, The Netherlands.
authors.forename: Job N
authors.initials: JN
authors.lastname: Doornberg
mesh_terms: D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D015588:Observer Variation; D009985:Orthopedics / Q000379:methods*; D011873:Radiology Information Systems; D015203:Reproducibility of Results; D012984:Software; D013978:Tibial Fractures / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Computed tomography; DICOM; MPEG; Orthopedic surgery; Tibial plateau fractures; Variation