Physiotherapist inter‐rater reliability of the Haemophilia Early Arthropathy Detection with Ultrasound protocol
Bibliographic record
Abstract
Introduction Prevention of arthropathy is the major goal of haemophilia treatment, and early detection of the first signs of joint damage is important so that prevention strategies can be initiated to limit physical disability and improve quality of life. Aim The aim of this study was to determine the inter‐rater repeatability of the HEAD ‐ US protocol when performed by haemophilia physiotherapists. Methods Sixty‐three joints (21 elbows, 21 knees and 21 ankles) were examined in 21 patients (mean age; 29.14 ± 10.09 years) according to the HEAD ‐ US protocol by four of six physiotherapists blinded to clinical information. Inter‐rater repeatability was evaluated by comparing the concordance of scores between the different clinicians using weighted Kappa (κ w ) statistics and 95% confidence intervals. Results Substantial agreement was found when evaluating synovial hypertrophy (κ w = 0.69), articular cartilage (κ w = 0.60) and bone (κ w = 0.74). Near perfect repeatability (κ w > 0.80) was found when scoring synovitis profiles of the elbow joint and bone profiles of the knee joint. Repeatability was moderate for scoring synovitis and articular cartilage profiles of the ankle joint. A moderate correlation between HEAD ‐ US and HJHS was found for the elbow and ankle joint and a strong correlation for the knee joint. Discordance between clinical and ultrasound examination was 19.30%. Conclusion Overall, we found repeatability of the HEAD ‐ US protocol was good when performed by physiotherapists, and our results support the emerging view that US imaging complements the physical examination when screening and monitoring joint health of people with haemophilia at the point of care.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".