Inadequate Annotation and Its Impact on Pelvic Tilt Measurement in Clinical Practice
Accurate pre-surgical templating of the pelvic tilt (PT) angle is essential for hip and spine surgeries, yet the reliability of PT annotations is often compromised by human error, inherent subjectivity, and variations in radiographic quality. This study aims to identify challenges leading to inadequ...
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Published in | Journal of clinical medicine Vol. 13; no. 5; p. 1394 |
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Language | English |
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Abstract | Accurate pre-surgical templating of the pelvic tilt (PT) angle is essential for hip and spine surgeries, yet the reliability of PT annotations is often compromised by human error, inherent subjectivity, and variations in radiographic quality. This study aims to identify challenges leading to inadequate annotations at a landmark dimension and evaluating their impact on PT.
We retrospectively collected 115 consecutive sagittal radiographs for the measurement of PT based on two definitions: the anterior pelvic plane and a line connecting the femoral head's centre to the sacral plate's midpoint. Five annotators engaged in the measurement, followed by a secondary review to assess the adequacy of the annotations across all the annotators.
The outcomes indicated that over 60% images had at least one landmark considered inadequate by the majority of the reviewers, with poor image quality, outliers, and unrecognized anomalies being the primary causes. Such inadequacies led to discrepancies in the PT measurements, ranging from -2° to 2°.
This study highlights that landmarks annotated from clear anatomical references were more reliable than those estimated. It also underscores the prevalence of suboptimal annotations in PT measurements, which extends beyond the scope of traditional statistical analysis and could result in significant deviations in individual cases, potentially impacting clinical outcomes. |
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AbstractList | BACKGROUNDAccurate pre-surgical templating of the pelvic tilt (PT) angle is essential for hip and spine surgeries, yet the reliability of PT annotations is often compromised by human error, inherent subjectivity, and variations in radiographic quality. This study aims to identify challenges leading to inadequate annotations at a landmark dimension and evaluating their impact on PT.METHODSWe retrospectively collected 115 consecutive sagittal radiographs for the measurement of PT based on two definitions: the anterior pelvic plane and a line connecting the femoral head's centre to the sacral plate's midpoint. Five annotators engaged in the measurement, followed by a secondary review to assess the adequacy of the annotations across all the annotators.RESULTSThe outcomes indicated that over 60% images had at least one landmark considered inadequate by the majority of the reviewers, with poor image quality, outliers, and unrecognized anomalies being the primary causes. Such inadequacies led to discrepancies in the PT measurements, ranging from -2° to 2°.CONCLUSIONThis study highlights that landmarks annotated from clear anatomical references were more reliable than those estimated. It also underscores the prevalence of suboptimal annotations in PT measurements, which extends beyond the scope of traditional statistical analysis and could result in significant deviations in individual cases, potentially impacting clinical outcomes. Background: Accurate pre-surgical templating of the pelvic tilt (PT) angle is essential for hip and spine surgeries, yet the reliability of PT annotations is often compromised by human error, inherent subjectivity, and variations in radiographic quality. This study aims to identify challenges leading to inadequate annotations at a landmark dimension and evaluating their impact on PT. Methods: We retrospectively collected 115 consecutive sagittal radiographs for the measurement of PT based on two definitions: the anterior pelvic plane and a line connecting the femoral head’s centre to the sacral plate’s midpoint. Five annotators engaged in the measurement, followed by a secondary review to assess the adequacy of the annotations across all the annotators. Results: The outcomes indicated that over 60% images had at least one landmark considered inadequate by the majority of the reviewers, with poor image quality, outliers, and unrecognized anomalies being the primary causes. Such inadequacies led to discrepancies in the PT measurements, ranging from −2° to 2°. Conclusion: This study highlights that landmarks annotated from clear anatomical references were more reliable than those estimated. It also underscores the prevalence of suboptimal annotations in PT measurements, which extends beyond the scope of traditional statistical analysis and could result in significant deviations in individual cases, potentially impacting clinical outcomes. Accurate pre-surgical templating of the pelvic tilt (PT) angle is essential for hip and spine surgeries, yet the reliability of PT annotations is often compromised by human error, inherent subjectivity, and variations in radiographic quality. This study aims to identify challenges leading to inadequate annotations at a landmark dimension and evaluating their impact on PT. We retrospectively collected 115 consecutive sagittal radiographs for the measurement of PT based on two definitions: the anterior pelvic plane and a line connecting the femoral head's centre to the sacral plate's midpoint. Five annotators engaged in the measurement, followed by a secondary review to assess the adequacy of the annotations across all the annotators. The outcomes indicated that over 60% images had at least one landmark considered inadequate by the majority of the reviewers, with poor image quality, outliers, and unrecognized anomalies being the primary causes. Such inadequacies led to discrepancies in the PT measurements, ranging from -2° to 2°. This study highlights that landmarks annotated from clear anatomical references were more reliable than those estimated. It also underscores the prevalence of suboptimal annotations in PT measurements, which extends beyond the scope of traditional statistical analysis and could result in significant deviations in individual cases, potentially impacting clinical outcomes. |
Audience | Academic |
Author | Chai, Yuan Boudali, A Mounir Rackel, Brooke Walter, William L Maes, Vincent |
AuthorAffiliation | 3 Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia; brac4608@uni.sydney.edu.au 1 Sydney Musculoskeletal Health and The Kolling Institute, Northern Clinical School, Faculty of Medicine and Health and the Northern Sydney Local Health District, Sydney, NSW 2006, Australia; mounir.boudali@sydney.edu.au (A.M.B.); bill.walter@hipknee.com.au (W.L.W.) 2 Department of Orthopaedics and Traumatic Surgery, Royal North Shore Hospital, St. Leonards, NSW 2065, Australia; drvincentmaes@gmail.com |
AuthorAffiliation_xml | – name: 3 Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia; brac4608@uni.sydney.edu.au – name: 2 Department of Orthopaedics and Traumatic Surgery, Royal North Shore Hospital, St. Leonards, NSW 2065, Australia; drvincentmaes@gmail.com – name: 1 Sydney Musculoskeletal Health and The Kolling Institute, Northern Clinical School, Faculty of Medicine and Health and the Northern Sydney Local Health District, Sydney, NSW 2006, Australia; mounir.boudali@sydney.edu.au (A.M.B.); bill.walter@hipknee.com.au (W.L.W.) |
Author_xml | – sequence: 1 givenname: Yuan orcidid: 0000-0001-6977-6155 surname: Chai fullname: Chai, Yuan organization: Sydney Musculoskeletal Health and The Kolling Institute, Northern Clinical School, Faculty of Medicine and Health and the Northern Sydney Local Health District, Sydney, NSW 2006, Australia – sequence: 2 givenname: Vincent orcidid: 0000-0002-6345-1998 surname: Maes fullname: Maes, Vincent organization: Department of Orthopaedics and Traumatic Surgery, Royal North Shore Hospital, St. Leonards, NSW 2065, Australia – sequence: 3 givenname: A Mounir surname: Boudali fullname: Boudali, A Mounir organization: Sydney Musculoskeletal Health and The Kolling Institute, Northern Clinical School, Faculty of Medicine and Health and the Northern Sydney Local Health District, Sydney, NSW 2006, Australia – sequence: 4 givenname: Brooke surname: Rackel fullname: Rackel, Brooke organization: Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia – sequence: 5 givenname: William L surname: Walter fullname: Walter, William L organization: Department of Orthopaedics and Traumatic Surgery, Royal North Shore Hospital, St. Leonards, NSW 2065, Australia |
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Cites_doi | 10.1007/s00586-014-3739-3 10.1080/17453670510041501 10.2519/jospt.2008.2680 10.3390/diagnostics13081411 10.1016/j.spinee.2012.02.013 10.1016/S2589-7500(22)00022-X 10.1016/0002-9416(83)90322-6 10.1007/s11999-012-2700-1 10.1148/ryai.2020190043 10.3310/hta16140 10.2106/JBJS.K.01591 10.1007/s005860050038 10.1007/s00586-022-07155-5 10.1097/BRS.0000000000000532 10.1038/s41598-021-87141-x 10.1186/s12891-016-1269-3 10.22603/ssrr.2023-0050 10.1007/s11999-010-1447-9 10.1016/j.arth.2023.10.035 10.1097/BRS.0000000000002433 10.1097/01.blo.0000238809.72164.54 10.1007/s11832-016-0713-0 10.1016/j.jcm.2016.02.012 10.1007/s12306-023-00772-3 10.1259/bjr/29690721 10.14444/2042 10.1007/s00586-014-3300-4 10.1097/CORR.0000000000002650 10.1007/s00586-022-07189-9 10.1177/15563316221136128 10.14245/ns.1836054.027 10.1016/j.arth.2014.07.009 10.1007/s11999-009-1064-7 10.1007/s00586-008-0755-1 10.1097/01.bsd.0000117542.88865.77 |
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Snippet | Accurate pre-surgical templating of the pelvic tilt (PT) angle is essential for hip and spine surgeries, yet the reliability of PT annotations is often... Background: Accurate pre-surgical templating of the pelvic tilt (PT) angle is essential for hip and spine surgeries, yet the reliability of PT annotations is... BACKGROUNDAccurate pre-surgical templating of the pelvic tilt (PT) angle is essential for hip and spine surgeries, yet the reliability of PT annotations is... |
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StartPage | 1394 |
SubjectTerms | Accuracy Annotations Clinical medicine Datasets Engineers Error analysis Evaluation Methods Orthopedics Pelvis Physiological aspects Preoperative care Quality management Radiography, Medical Standing position Surgeons Transplants & implants |
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Title | Inadequate Annotation and Its Impact on Pelvic Tilt Measurement in Clinical Practice |
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