The purpose of this thesis project was to assess the value of chest radiographs as a screening tool for the diagnosis of diffuse idiopathic skeletal hyperostosis (DISH). Two "gold standard" physicians identified 45 DISH patients and 106 control patients (45 with thoracic spondylosis, 45 with "normal" spines, and 16 with ankylosing spondylitis). The chest x-rays on the 151 subjects were randomized and read independently using an ordinal diagnostic certainty scale by two "test" radiologists, experienced in reading bone radiographs. The average results for the two test radiologists were: sensitivity = 77%; specificity = 97%; positive predictive value = 91%; and, negative predictive value = 91%. The area under the receiver operating characteristic curves was 0.975 and 0.976 for the radiologists, respectively, suggesting that inter-rater reliability was very high. A second reading showed that the intra-rater reliability was exceptional (weighted kappa of 0.90 and 0.96 for the two "test" radiologists). DISH patients whose chest x-rays were read as not demonstrating DISH had significantly less extensive disease. We conclude that chest x-rays are a reliable and valid screening tool for the diagnosis of DISH.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.69737 |
| Date | January 1993 |
| Creators | Mata, Sonia |
| Contributors | Esdaile, John M. (advisor) |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Master of Science (Department of Epidemiology and Biostatistics.) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | alephsysno: 001350911, proquestno: AAIMM91853, Theses scanned by UMI/ProQuest. |
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