Observer agreement of imaging measurements used for evaluation of dentofacial deformity in juvenile idiopathic arthritis
AuthorFischer, Johannes Maria; Halbig, Josefine Mareile; Augdal, Thomas Angell; Angenete, Oskar W; Stoustrup, Peter; Kristensen, Kasper Dahl; Skeie, Marit Slåttelid; Tylleskär, Karin; Rosén, Annika; Shi, Xie-Qi; Rosendahl, Karen
Methods: Those included were children diagnosed with JIA during 2015–18 who had had an MRI, a CBCT of the temporomandibular joints (TMJs) and a lateral cephalogram (ceph) of the head within one month of each other. Agreement within and between observers and methods was examined using Bland-Altman mean-difference plots and 95% limits of agreement (LOA). A 95% LOA within 15% of the sample mean was considered acceptable. Minimal detectable change (MDC) within and between observers was estimated.
Results: 90 patients (33 males) were included, with a mean age of 12.8 years. For MRI, intra- and interobserver 95% LOA were relatively narrow for total mandibular length: 9.6% of the sample mean. For CBCT, condylar height, both intra- and interobserver 95% LOA were wide: 16.0 and 28.4% of the sample mean, respectively. For ceph, both intra- and interobserver 95% LOA were narrow for the SNA-angle and gonion angle: 5.9 and 8% of the sample mean, and 6.2 and 6.8%, respectively.
Conclusions: We have identified a set of precise measurements for facial morphology assessments in JIA, including one MRI-based (total mandibular length), one CBCT-based (condylar height), and three ceph-based. Condylar height was higher for MRI than for CBCT; however, the measurement was too imprecise for clinical use. MDC was also determined for a series of measurements.