Reliability assessment of the Biffl Scale for blunt traumatic cerebrovascular injury as detected on computer tomography angiography.

Abstract:

:OBJECTIVE Blunt traumatic cerebrovascular injury (TCVI) represents structural injury to a vessel due to high-energy trauma. The Biffl Scale is a widely accepted grading scheme for these injuries that was developed using digital subtraction angiography. In recent years, screening CT angiography (CTA) has been used to identify patients with TCVI. The reliability of this scale, with injuries assessed using CTA, has not yet been determined. METHODS Seven independent raters, including 2 neurosurgeons, 2 neuroradiologists, 2 neurosurgical residents, and 1 neurosurgical vascular fellow, independently reviewed each presenting CTA of the neck performed in 40 patients with confirmed TCVI and assigned a Biffl grade. Ten images were repeated to assess intrarater reliability, for a total of 50 CTAs. Fleiss' multirater kappa (κ) and interclass correlation were calculated as a measure of interrater reliability. Weighted Cohen's κ was used to assess intrarater reliability. RESULTS Fleiss' multirater κ was 0.65 (95% CI 0.61-0.69), indicating substantial agreement as to the Biffl grade assignment among the 7 raters. Interclass correlation was 0.82, demonstrating excellent agreement among the raters. Intrarater reliability was perfect (weighted Cohen's κ = 1) in 2 raters, and near perfect (weighted Cohen's κ > 0.8) in the remaining 5 raters. CONCLUSIONS Grading of TCVI with CTA using the Biffl Scale is reliable.

journal_name

J Neurosurg

journal_title

Journal of neurosurgery

authors

Foreman PM,Griessenauer CJ,Kicielinski KP,Schmalz PGR,Rocque BG,Fusco MR,Sullivan JC 3rd,Deveikis JP,Harrigan MR

doi

10.3171/2016.7.JNS16849

subject

Has Abstract

pub_date

2017-07-01 00:00:00

pages

32-35

issue

1

eissn

0022-3085

issn

1933-0693

journal_volume

127

pub_type

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