Effect Of Clinician'S Experience And Expertise On The Inter- And Intra-Observer Reliability Of Hip Migration Index In Children With Cerebral Palsy A Strobe-Compliant Retrospective Study

Few studies have investigated the reliability of Reimers' hip migration percentage (RMP) in children with cerebral palsy (CP). Most studies on the topic reflected rating results of physician with a similar level of experience from the same expertise. This study aimed to determine the effect of clinician's experience and expertise on the intra-and inter-observer reliability of RMP. In this retrospective observational study, hip radiographs of children with CP were identified. 5 observers with different degrees of working experience from 3 different clinical fields, including orthopedics, radiology, and physical medicine and rehabilitation, performed all RMP measurements. All measurements were repeated 6 weeks later by the same observers. Inter- and intra-observer reliability for RMP measurements were assessed using Intraclass Correlation Coeficient (ICC), calculated from 2 sets of repeated measurements on a subset of 50 hips, with a 6 week apart for each observer. Fifty hip radiographs of 25 children with CP (10 females and 15 males; mean age: 6 years; age range: 2-8 years) were examined in the current study. No significant differences existed in intra-and inter-observer measurements. Excellent intra-observer reliability was observed between the 2 separate measurements for each observer, with a mean ICC of 0.976 (range: 0.956-0.989; P < .001). Among 5 observers, inter-observer reliability was excellent for the 2 separate RMP measurements, with the mean ICC minimally increasing between the 2 measurement periods (mean ICC: 0.928, range: 0.838-0.979 and mean ICC: 0.936, range: 0.861-0.983, respectively) (P < .001). Clinician's experience and expertise may not affect inter-and intra-observer reliability of RMP measurements.