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Comparative Study
. 2017 Oct;30(5):547-554.
doi: 10.1007/s10278-016-9939-0.

Online Studies on Variation in Orthopedic Surgery: Computed Tomography in MPEG4 Versus DICOM Format

Jos J Mellema  1 , Wouter H Mallee  2 , Thierry G Guitton  2 , C Niek van Dijk  2 , David Ring  3 , Job N Doornberg  2 ; Science of Variation Group & Traumaplatform Study Collaborative
Collaborators, Affiliations
Comparative Study

Online Studies on Variation in Orthopedic Surgery: Computed Tomography in MPEG4 Versus DICOM Format

Jos J Mellema et al. J Digit Imaging. 2017 Oct.

Abstract

The purpose of this study was to compare the observer participation and satisfaction as well as interobserver reliability between two online platforms, Science of Variation Group (SOVG) and Traumaplatform Study Collaborative, for the evaluation of complex tibial plateau fractures using computed tomography in MPEG4 and DICOM format. A total of 143 observers started with the online evaluation of 15 complex tibial plateau fractures via either the SOVG or Traumaplatform Study Collaborative websites using MPEG4 videos or a DICOM viewer, respectively. Observers were asked to indicate the absence or presence of four tibial plateau fracture characteristics and to rate their satisfaction with the evaluation as provided by the respective online platforms. The observer participation rate was significantly higher in the SOVG (MPEG4 video) group compared to that in the Traumaplatform Study Collaborative (DICOM viewer) group (75 and 43%, respectively; P < 0.001). The median observer satisfaction with the online evaluation was seven (range, 0-10) using MPEG4 video compared to six (range, 1-9) using DICOM viewer (P = 0.11). The interobserver reliability for recognition of fracture characteristics in complex tibial plateau fractures was higher for the evaluation using MPEG4 video. In conclusion, observer participation and interobserver reliability for the characterization of tibial plateau fractures was greater with MPEG4 videos than with a standard DICOM viewer, while there was no difference in observer satisfaction. Future reliability studies should account for the method of delivering images.

Keywords: Computed tomography; DICOM; MPEG; Orthopedic surgery; Tibial plateau fractures; Variation.

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Conflict of interest statement

Conflict of Interest

Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements) that might pose a conflict of interest in connection with the submitted article.

Ethical Review Committee

The Institutional Review Board of our institution approved this study under protocol #2009P001019/MGH.

The Location Where the Work Was Performed

The work was performed at the Hand and Upper Extremity Service, Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA and Department of Orthopedic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

Figures

Fig. 1
Fig. 1
The online evaluation of computed tomography scans of complex tibial plateau fractures. a Science of Variation Group provided CT scans converted into videos (MPEG4 format). Observers were able to play and scroll through the MPEG4 videos of transverse, sagittal, and coronal planes. b The Traumaplatform Study Collaborative provided CT scans displayed in built-in DICOM viewers. Observers were able to window level, scale, position, rotate, and scroll back and forth through transverse, sagittal, and coronal planes
See this image and copyright information in PMC

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