External caliper-based measurements of the modified percent depth as an alternative to cross-sectional imaging for assessing the severity of pectus excavatum
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In brief
In brief
This prospective study validates external caliper measurements (Modified Percent Depth) as an accurate alternative to cross-sectional imaging for assessing pectus excavatum severity in children aged 11-21. The MPD demonstrated comparable diagnostic accuracy to traditional radiographic indices (Haller Index, Correction Index) with high interrater reliability, potentially reducing unnecessary imaging exposure in pediatric patients.
Written by the GCMD Library team from the article.
Background
Cross-sectional imaging (CSI) may be clinically unnecessary in the evaluation of pectus excavatum (PE). The purpose of our study was to prospectively evaluate the accuracy and reliability of the modified percent depth (MPD), derived from caliper-based external measurements, in identifying PE.
Methods
Children 11–21 years old presenting for evaluation of PE or to obtain thoracic cross-sectional imaging for other indications were measured to derive the Modified Percent Depth. The Haller Index (HI) and Correction Index (CI) were calculated from CSI. Receiver–Operator Characteristic (ROC) analysis was used to compare the sensitivity and specificity of MPD, HI, and CI. Interrater reliability was assessed using Spearman's correlation coefficient and Cohen's Kappa coefficient.
Results
Of 199 patients, 76 (38%) had severe PE. Median age was 16 years (range = 11–21). The median Modified Percent Depth was 21.4% (IQR = 16.2–26.3) among those with PE versus 4.1% (IQR = 1.7–6.4) in those without (p 0.71, p