INTRA- AND INTER-RATER RELIABILITY OF A BIOPHOTOGRAMMETRIC ASSESSMENT PROTOCOL FOR PRETERM INFANTS

Campos, Juliana Vieira; Moreno, Mariana Alves; Silva, Ricardo de Bastos; Silva, Jessica Neves Quirino da; Carvalho, Milena Ferreira de; Santos, Rayssa Christina Abreu dos; Peres, Rodrigo Tosta; Santos, Rosana da Silva; Ferreira, Halina Cidrini

doi:10.1590/1984-0462/2021/39/2020034

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Brasil

Revista Paulista de Pediatria

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ORIGINAL ARTICLE • Rev. paul. pediatr. 39 • 2021 • https://doi.org/10.1590/1984-0462/2021/39/2020034 copy

INTRA- AND INTER-RATER RELIABILITY OF A BIOPHOTOGRAMMETRIC ASSESSMENT PROTOCOL FOR PRETERM INFANTS

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To measure the intra- and inter-rater reliability of a biophotogrammetric assessment protocol for thoracoabdominal motion in preterm infants.

Methods:

This is an analytical cross-sectional study. Footage of 40 preterm infants was made in two views (lateral and anterior). The babies were placed in the supine position, with retroverted pelvis and semiflexed knees. Acrylic markers were positioned on surgical tape in eight predetermined anatomical points. We analyzed 4 variables in lateral view and 11 in anterior view (angular and linear) (ImageJ^®), divided into two stages: 1. same frames - three blinded evaluators analyzed frames previously selected by the main researcher (inter-rater analysis 1), reviewing these same frames after 15 days (intra-rater analysis 1); 2. different frames - each evaluator selected the frames from the original video and repeated the protocol (inter-rater analysis 2), with a review after 15 days (intra-rater analysis 2). In stage 2, we tested the reliability of the entire process, from image selection to the analysis of variables. Data agreement and reproducibility were obtained by the intraclass correlation coefficient (ICC).

Results:

Agreement was high, particularly in angular variables (ICC 0.82 to 0.99). Linear variables ranged between very good and excellent in analysis 1 (same frames: ICC 0.64 to 0.99) and analysis 2 (different frames: ICC 0.44 to 0.89).

Conclusions:

The present study suggests that the proposed protocol for the thoracoabdominal motion analysis of preterm neonates has high reliability.

Keywords:
Infant, premature; Physical therapy modalities; Photogrammetry

	Same frames		Different frames
	Moment 1	Moment 2	Moment 1	Moment 2
A1(c)	0.98 (0.96; 0.99)	0.97 (0.95; 0.98)	0.94 (0.88; 0.97)	0.95 (0.92; 0.97)
A1(x)	0.98 (0.98; 0.99)	0.98 (0.97; 0.98)	0.96 (0.95; 0.98)	0.95 (0.93; 0.97)
DTL(c)	0.73 (0.63; 0.81)	0.63 (0.46; 0.75)	0.62 (0.45; 0.74)	0.52 (0.25; 0.70)
DTL(x)	0.73 (0.62; 0.82)	0.63 (0.41; 0.77)	0.63 (0.46; 0.76)	0.56 (0.36; 0.70)
DGAe	0.80 (0.56; 0.90)	0.87 (0.80; 0.92)	0.68 (0.58; 0.77)	0.59 (0.47; 0.70)
DGAd	0.84 (0.57; 0.93)	0.90 (0.85; 0.93)	0.70 (0.60; 0.78)	0.80 (0.71; 0.86)
DGX	0.74 (0.44; 0.86)	0.88 (0.83; 0.92)	0.65 (0.54; 0.75)	0.68 (0.54; 0.78)
DTA(x)	0.64 (0.31; 0.80)	0.85 (0.74; 0.91)	0.56 (0.43; 0.68)	0.73 (0.54; 0.83)
DTA(c)	0.70 (0.39; 0.84)	0.88 (0.78; 0.93)	0.59 (0.46; 0.69)	0.75 (0.59; 0.85)
DXAe	0.54 (0.29; 0.71)	0.76 (0.63; 0.84)	0.49 (0.36; 0.61)	0.63 (0.44; 0.76)
DXAd	0.52 (0.28; 0.69)	0.81 (0.70; 0.88)	0.47 (0.34; 0.60)	0.61 (0.46; 0.73)
A2(c)	0.99 (0.98; 0.99)	0.95 (0.93; 0.97)	0.87 (0.82; 0.91)	0.84 (0.78; 0.89)
A2(x)	0.98 (0.96; 0.99)	0.96 (0.95; 0.97)	0.88 (0.83; 0.92)	0.84 (0.78; 0.89)
A2(a)	0.99 (0.98; 0.99)	0.94 (0.91; 0.96)	0.89 (0.84; 0.92)	0.83 (0.76; 0.88)
A3	0.95 (0.93; 0.97)	0.91 (0.88; 0.94)	0.88 (0.83; 0.92)	0.88 (0.83; 0.91)

	Rater 1	Rater 2	Rater 3
A1(c)	0.99 (0.98; 0.99)	0.99 (0.98; 0.99)	0.99 (0.98; 0.99)
A1(x)	0.99 (0.98; 0.99)	0.99 (0.99; 1)	0.99 (0.98; 0.99)
DTL(c)	0.76 (0.65; 0.84)	0.90 (0.84; 0.93)	0.85 (0.74; 0.88)
DTL(x)	0.77 (0.66; 0.85)	0.92 (0.87; 0.94)	0.82 (0.78; 0.90)
DGAe	0.91 (0.86; 0.94)	0.95 (0.92; 0.97)	0.86 (0.79; 0.91)
DGAd	0.93 (0.89; 0.95)	0.96 (0.94; 0.97)	0.86 (0.79; 0.91)
DGX	0.86 (0.79; 0.91)	0.92 (0.87; 0.95)	0.84 (0.76; 0.89)
DTA(x)	0.80 (0.70; 0.86)	0.87 (0.81; 0.92)	0.82 (0.73; 0.88)
DTA(c)	0.85 (0.77; 0.90)	0.90 (0.85; 0.93)	0.86 (0.79; 0.91)
DXAe	0.70 (0.56; 0.79)	0.85 (0.77; 0.90)	0.68 (0.54; 0.78)
DXAd	0.71 (0.58; 0.80)	0.82 (0.73; 0.88)	0.70 (0.57; 0.80)
A2(c)	0.99 (0.99; 0.99)	0.99 (0.99; 0.99)	0.94 (0.91; 0.96)
A2(x)	0.99 (0.98; 0.99)	0.99 (0.99; 1)	0.95 (0.93; 0.97)
A2(a)	0.99 (0.98; 0.99)	0.99 (0.99; 1)	0.92 (0.88; 0.95)
A3	0.96 (0.94; 0.97)	0.98 (0.97; 0.99)	0.91 (0.86; 0.94)

	Rater 1	Rater 2	Rater 3
A1(c)	0.97 (0.95; 0.98)	0.95 (0.93; 0.97)	0.99 (0.98; 0.99)
A1(x)	0.98 (0.96; 0.99)	0.96 (0.94; 0.98)	0.99 (0.99; 1)
DTL(c)	0.61 (0.45; 0.73)	0.79 (0.68; 0.86)	0.80 (0.70; 0.87)
DTL(x)	0.56 (0.39; 0.69)	0.78 (0.68; 0.86)	0.76 (0.65; 0.84)
DGAe	0.67 (0.53; 0.78)	0.56 (0.39; 0.70)	0.78 (0.68; 0.85)
DGAd	0.68 (0.54; 0.78)	0.77 (0.67; 0.85)	0.84 (0.75; 0.89)
DGX	0.64 (0.49; 0.75)	0.70 (0.57; 0.80)	0.78 (0.68; 0.85)
DTA(x)	0.48 (0.29; 0.63)	0.81 (0.72; 0.87)	0.82 (0.74; 0.88)
DTA(c)	0.58 (0.41; 0.71)	0.84 (0.75; 0.89)	0.85 (0.78; 0.90)
DXAe	0.57 (0.41; 0.70)	0.63 (0.47; 0.74)	0.65 (0.51; 0.76)
DXAd	0.54 (0.37; 0.68)	0.55 (0.38; 0.69)	0.67 (0.53; 0.77)
A2(c)	0.88 (0.81; 0.92)	0.83 (0.74; 0.88)	0.92 (0.88; 0.95)
A2(x)	0.89 (0.84; 0.93)	0.80 (0.70; 0.87)	0.93 (0.89; 0.95)
A2(a)	0.87 (0.80; 0.91)	0.84 (0.76; 0.89)	0.86 (0.79; 0.91)
A3	0.88 (0.82; 0.92)	0.85 (0.78; 0.90)	0.91 (0.86; 0.94)

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[1] *Corresponding author. E-mail: halinacidrini@me.ufrj.br (H.C. Ferreira).

A	Lateral view	Schematic representation
A	Definition	Schematic representation
A1(c)	Angle between the lateral costal marker, the apex of the head, and the xiphoid process.
A1(x)	Angle between the lateral xiphoid marker, the apex of the head, and the xiphoid process.
DTL(c)	Lateral thoracic distance between the lateral costal markers.
DTL(x)	Lateral thoracic distance between the lateral xiphoid markers.
B	Anterior view	Illustration
B	Definition	Illustration
DGAe	Distance between the glabella and the left acromion.
DGAd	Distance between the glabella and the right acromion.
DGX	Distance between the glabella and the xiphoid process.
DTA(x)	Anterior distance between the xiphoid markers.
DTA(c)	Anterior distance between the costal markers.
DXAe	Distance between the xiphoid process and the left acromion.
DXAd	Distance between the xiphoid process and the right acromion.
A2(c)	Angle between the glabella and the lateral costal markers.
A2(x)	Angle between the glabella and the lateral xiphoid markers.
A2(a)	Angle between the glabella and the right and left acromion.
A3	Angle between the xiphoid process and the lateral costal markers.