StayCurrentMD · Evaluating Inter- and Intraobserver Agreement on Pectus Carinatum Severity and Treatment Outcomes: A Comparison of Subjective and Objective Assessment Methods
Article1 min read·Published Dec 2024

Evaluating Inter- and Intraobserver Agreement on Pectus Carinatum Severity and Treatment Outcomes: A Comparison of Subjective and Objective Assessment Methods

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Article · Dec 2024 · 1 min read

In brief

In brief

This study examines how reliably surgeons and peers assess pectus carinatum severity and treatment outcomes using visual examination of medical photographs. Researchers evaluated inter- and intraobserver agreement across 201 pediatric patients treated with either Ravitch surgery or dynamic compression bracing, finding inadequate consistency in subjective assessments.

  • Visual assessment of pectus carinatum shows poor inter- and intraobserver reliability among both surgeons and peers (inadequate κ values).
  • Subjective evaluation of PC severity and treatment outcomes lacks consistency, highlighting need for objective measurement tools.
  • Agreement on esthetic results after Ravitch surgery vs dynamic compression bracing was insufficient for reliable clinical decision-making.
  • Factors like surgical scars, patient age, and treatment duration did not improve observer agreement on cosmetic outcomes.
  • Standardized objective assessment methods are needed to replace subjective visual examination in PC management.

Written by the GCMD Library team from the article.

Background Visual examination is crucial for assessing pectus carinatum (PC) severity and treatment results. This cross-sectional study evaluates the inter- and intraobserver agreement of PC deformities before and after treatment. Methods Observers examined medical photographs of patients before and after treatment. Primary outcome was inter- and intraobserver agreement on esthetic results after treatment. Secondary outcomes included inter- and intraobserver agreement on severity and symmetry before treatment, differences in esthetic results after Ravitch surgery and dynamic compression bracing (DCS bracing), and the impact of scars, age, and treatment duration on esthetic results. Results Medical photographs of 201 patients (aged 4–18) were evaluated by five surgeons and five peers. Surgeons and peers demonstrated inadequate (κ 

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