Reliability and validity of subjective assessment of lumbar lordosis in conventional radiography

Background: Reliability and validity studies of different lumbar curvature analysis and measurement techniques have been documented however there is limited literature on the reliability and validity of subjective visual analysis. Radiological assessment of lumbar lordotic curve aids in early diagnosis of conditions even before neurologic changes set in.Objective: To ascertain the level of reliability and validity of subjective assessment of lumbar lordosis in conventional radiography.Design: A blinded, repeated-measures diagnostic test was carried out on lumbar spine x-ray radiographs.Setting: Radiology Department at Joint Clinical Research Centre (JCRC), Mengo- Kampala-Uganda.Subjects: Seventy (70) lateral lumbar x-ray films were used for this study and were obtained from the archive of JCRC radiology department at Butikiro house, Mengo- Kampala.Results: Poor observer agreement, both inter- and intra-observer, with kappa values of 0.16 was found. Inter-observer agreement was poorer than intra-observer agreement. Kappa values significantly rose when the lumbar lordosis was clustered into four categories without grading each abnormalityConclusion: The results confirm that subjective assessment of lumbar lordosis has low reliability and validity. Film quality has limited influence on the observer reliability. This study further shows that fewer scale categories of lordosis abnormalities produce better observer reliability

The triple assessment in the pre-operative evaluation of patients with breast cancer in Mulago Hospital, Kampala – Uganda

Background: Triple assessment has been recommended in diagnosis of Breast cancer in Uganda. This review analyses its diagnostic value in patients presenting with clinically malignant breast lumps.Objective: To establish the validity and reliability of the triple assessment in the pre-operative evaluation of patients with breast cancer in Mulago Hospital.Methods: A total of 200 patients suspected to have breast cancer were evaluated. All patients underwent clinical evaluation, mammography and fine needle aspiration cytology. Histology was done to confirm the diagnosis.Results: A total of 200 patients were studied. The age ranged from 19 to 88 years. Sixty-six patients had benign lesions. There were 134 were breast cancer cases. With triple assessment, 84 patients were diagnostic for malignancy and 30 benign, respectively confirmed by histology. The Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value and Accuracy were respectively 100.0%. Error was 0.0%. The Kappa statistic for the combination was 1.0.Conclusions and Recommendations: The triple assessment is valid and reliable. Breast masses can be diagnosed with a high degree of accuracy by the triple assessment. Diagnostic open biopsy is mandated if the triple assessment results show a lack of concordance

Coarctation of aorta presenting as acute haemorrhagic stroke in a 14-year old. A case report

No Abstract African Health Sciences Vol. 8 (4) 2008: pp. 256-25

Utilisation of obstetric sonography at a peri-urban health centre in Uganda

No Abstract