Use this URL to cite or link to this record in EThOS: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.755639
Title: Reliability of Cervical Vertebrae Maturation (CVM) staging method using full versus cropped lateral cephalograms
Author: Mangan, Julia
Awarding Body: University of Liverpool
Current Institution: University of Liverpool
Date of Award: 2018
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Abstract:
Objectives: Staging of cervical vertebral maturation (CVMS) using full lateral cephalograms has been found reliable. However, visibility of the dentition may influence staging so using cropped images may reduce such bias. The primary objective of this study was to determine whether CVMS reliability was improved by using cropped images. The secondary objective was to determine whether the level of orthodontic experience affected CVM reliability. Design/setting: Two-phase reliability study, with a 3-month wash out period, of the modified CVMS method was undertaken over 2 consecutive audit meetings of Mersey and North Wales Audit Group during 2016. Methods: A group of 22 orthodontic clinicians were trained to use the modified CVMS method for the assessment of mandibular growth. 144 consecutive images, taken at Liverpool University Dental Hospital, in full or cropped format were independently assessed. The images were displayed on individual computer monitors, to replicate the clinical setting, in two different random orders. Intra- and inter-observer agreement were evaluated using weighted kappa, (KW) and Fleiss-Nee-Landis kappa, respectively. Results: Overall intra-observer agreements for cropped and full images were 'almost perfect' (quadratic KW 0.84, mean agreement 97%). The overall inter-observer agreement for cropped images was 'moderate' with values of 0.46 (95% CI 0.45-0.47) for phase 1 and 0.43 (95% CI 0.43-0.44) for phase 2, mean agreement of 87%). The overall inter-observer reliability for full images was 'fair-moderate' with values of 0.44 (95% CI 0.44-0.45) for phase 1 and 0.40 (95% CI 0.39-0.41) for phase 2, with mean agreement 86%. Intra- and inter-observer observer reliability of orthodontic trainees for cropped images were 0.76-0.95 and 0.50, respectively. Intra- and inter-observer observer reliability of orthodontic trainees for full images were 0.75-0.92 and 0.46, respectively. Intra- and inter-observer observer reliability of orthodontic specialist for cropped images were 0.65-0.89 and 0.44, respectively. Intra- and inter-observer observer reliability of orthodontic specialist for full images were 0.75-0.90 and 0.43, respectively. Conclusions: The intra-observer agreement values for classifying the vertebral stages with the CVM method were 'almost perfect'. The inter-observer agreement for classifying the vertebral stages with the CVM method were 'fair to moderate'. The use of cropped images did not improve CVMS reliability. Clinical experience did not improve CVM staging reliability.
Supervisor: Harrison, Jayne E. ; Burnside, Girvan Sponsor: Not available
Qualification Name: Thesis (D.D.Sc.) Qualification Level: Doctoral
EThOS ID: uk.bl.ethos.755639  DOI:
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