Observer Variability in Scoring Abdominal Aortic Calcifications and Vertebral Morphometry

NCT03839732 | Completed

• 1 other identifier: CE AVEC 695/2018/Oss/IOR
• Study Type: observational
• Target: 44
• Locations: 1 country
• Sites: 1

Brief Summary

BACKGROUND In the context of a progressively aging population, monitoring the status of Vascular Calcifications (VC) and Vertebral Fractures (VF) over time would be of primary importance, as VC and VF are recognized to be hallmarks of severe cardiovascular events (hospitalization and/or death) and hip fractures respectively, and VF represent an under-diagnosed cause of progressive disability and pain on its own. Moreover, there is an acknowledged relationships between VC and VF. However, data about the emergence/progression of VC and the emergence/worsening of VF over time are lacking. This is likely due to the absence of monitoring instruments for VC and VF that are both precise and easily accessible/applicable. OBJECTIVE This study aims to define the observer variability of a new software developed by the study sponsor and collaborators, called Calcify2D. Calcify2D offers physicians a computer-assisted procedure to simultaneously score vascular calcifications at the abdominal aorta and lumbar vertebral fractures (according to Quantitative Vertebral Morphometry principles) based on a latero-lateral thoracolumbar spine radiography. Secondary aims are the validation of the scores obtained from latero-lateral thoracolumbar spine radiography with more invasive and/or costly gold-standard imaging modalities (Computed Tomography for VC, Magnetic Resonance for VF) that may have been acquired near-simultaneously to radiographs on the patients enrolled for the study. STUDY DESIGN Not-for-profit monocentric observational study to be conducted on the diagnostic images of the thoracolumbar spine already collected at Istituto Ortopedico Rizzoli (IOR) within a previous interventional study. Scoring of VC and VF will be performed by four clinicians from four relevant specialties, chosen among those who may often see VC and VF and are already familiar with the traditional scoring systems for both VC and VF (one radiologist and one spine orthopaedics from IOR, one nephrologist from the National Research Council and one internist from University of Padua). Each clinician will assess all radiographs to score VC and QVM, both via computer assisted procedures and via traditional visual inspection. To avoid bias, an interval of at least one week will be left between the computer assisted and visual scoring. To define intra-observer variability (i.e. repeatability), the whole dataset will be re-assessed three times.

Conditions

Vascular Calcification; Vertebral Fracture

Keywords

observer variability; kauppila score; quantitative vertebral morphometry; computer assisted procedure; abdominal aorta; lumbar spine

Outcome Measures

Primary Outcomes (1)

• Observer variability in scoring Vascular Calcification at the abdominal aorta

  Observer variability (repeatability and reproducibility) in the assessment of vascular calcifications at the abdominal aorta according to a widely adopted scoring system (Kauppila et al., 1997): comparison between computer assisted and visual scoring.

  through study completion, 1 year at maximum

Secondary Outcomes (3)

• Observer variability in scoring Vertebral Fractures at the lumbar spine

  through study completion, 1 year at maximum

• Accuracy of computer assisted VC score

  through study completion, 1 year at maximum

• Accuracy of computer assisted QVM

  through study completion, 1 year at maximum

Study Arms (1)

Vascular Calcification Group

Patients with prevalent vascular calcifications will be analysed to verify the intra- and inter-observer reliability of the score of abdominal aorta calcifications

Diagnostic Test: Score of abdominal aorta calcifications

Interventions

Score of abdominal aorta calcifications DIAGNOSTIC_TEST

Radiographs showing VC will be used to assess whether the computer assisted VC scoring (primary objective) and Quantitative Vertebral Morphometry (QVM, limited to lumbar spine, secondary objective n.1) through the Calcify2D software are less variable with respect to the traditional visual scoring of VC and QVM.

Also known as: Score of lumbar spine vertebral fractures

Vascular Calcification Group

Eligibility Criteria

• Age: 20 Years+
• Sex: all
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All patients that were included in a previous interventional trial of the sponsor institution aimed to compare the effectiveness of vertebroplastic and kyphoplastic augmentations of the throracolumbar spine. The choice of this population was driven by previous reports on similar populations stating a high prevalence of vascular calcifications.

You may qualify if:

• Patients included in a previous interventional study (VTP vs KYPHO) of the sponsor.
• Availability of diagnostic images (Dorso-lumbar radiographies taken in L-L projection).
• Rx images will be screened for the presence of VC, retaining only those showing VC.
• Informed consent obtained prior to any study analysis-evaluation.

You may not qualify if:

• Images showing severe artefacts (usually due to presence of metallic devices) that alter the grayscale range and hinder correct identification of VC and vertebral fractures

Sponsors & Collaborators

• Istituto Ortopedico Rizzoli: lead
• Fondazione C.N.R./Regione Toscana "G. Monasterio", Pisa, Italy: collaborator
• University of Padova: collaborator

Study Sites (1)

Istituto Ortopedico Rizzoli

Bologna, BO, 40136, Italy

Location

MeSH Terms

Conditions

Vascular Calcification; Spinal Fractures

Condition Hierarchy (Ancestors)

Calcinosis; Calcium Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Spinal Injuries; Back Injuries; Wounds and Injuries; Fractures, Bone

Study Officials

• Enrico Schileo, Ph.D.

  Istituto Ortopedico Rizzoli

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 8, 2019
• First Posted: February 15, 2019
• Study Start: November 28, 2018
• Primary Completion: October 31, 2019
• Study Completion: April 27, 2021
• Last Updated: May 24, 2023

Record last verified: 2023-05

Locations

IT (1)