Reliability of renal ultrasound measurements in children
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ORIGINAL ARTICLE
Reliability of renal ultrasound measurements in children J. J. Miranda Geelhoed & Veronica E. Kleyburg-Linkers & Sonja P. E. Snijders & Maarten Lequin & Jeroen Nauta & Eric A. P. Steegers & Albert J. van der Heijden & Vincent W. V. Jaddoe
Received: 10 October 2008 / Revised: 3 February 2009 / Accepted: 3 February 2009 / Published online: 12 March 2009 # IPNA 2009
Abstract The aim of the investigation reported here was to assess the intraobserver and interobserver variability of renal measurements in children. The study comprised 56 paired measurements in 28 children (median age 7.5 years, range 3.0–15.0 years) without renal or ureterovesical anomalies. Intraobserver and interobserver reproducibility was assessed by repeated measurements of the left and right renal length, width, and thickness. Intraclass correlation coefficients (ICCs) with the corresponding 95% confidence interval (CI) were calculated. Bland and Altman plots were computed to assess the agreement of the measurements. Limits of agreement ± 2 standard deviations (SD) for the mean differences in renal measurements were derived. Intraobserver ICCs ranged from 0.93 (left and right renal J. J. M. Geelhoed : V. E. Kleyburg-Linkers : S. P. E. Snijders : V. W. V. Jaddoe (*) The Generation R Study Group (AE-006), Erasmus Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands e-mail: [email protected] J. J. M. Geelhoed : V. W. V. Jaddoe Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands J. J. M. Geelhoed : J. Nauta : A. J. van der Heijden : V. W. V. Jaddoe Department of Pediatrics, Erasmus Medical Center, Rotterdam, The Netherlands M. Lequin Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands E. A. P. Steegers Department of Obstetrics & Gynecology, Erasmus Medical Center, Rotterdam, The Netherlands
width and right renal thickness) to 0.99 (left renal length), and interobserver ICCs ranged from 0.64 (right renal thickness) to 0.90 (right renal length). Limits of agreement in the Bland and Altman plots ranged from −8.0 to 9.2% (intraobserver left renal width) to the widest limit from −18.0 to 19.2% (interobserver left renal length). Overall, this study demonstrated the good reproducibility and agreement of most renal dimensions in children measured by ultrasound (US). Based on these results, we conclude that US is an appropriate measure to assess renal dimensions in both clinical and epidemiological studies. Keywords Children . Intraobserver/interobserver variability . Renal dimensions . Ultrasound
Introduction Renal size is an important part of the assessment of the renal tract in pediatric patients. Many epidemiological studies use renal ultrasound (US) measurements to examine the associations of various determinants with renal size in children [1, 2]. This information may be relevant for identifying critical periods in life for renal growth and development [3]. Ultrasound is widely recognized as the method of choice for visualizing organs in children as it is noninvasive,
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