MEASUREMENT OF THE CONSISTENCY OF PATELLA-TENDON-BEARING MODIFICATION USING CAD
Bibliographic record
Abstract
Study design: Pilot studyBackground: Computer aided design (CAD) is now commonly used in prosthetic clinical practice. To create a patellar tendon bearing (PTB) socket, further modification of the transtibial shape is required. Objectives: To investigate the consistency of transtibial shape modification for a PTB socket design using CAD.Methods: 13 transtibial models with marked anatomical landmarks were made, each linked to a fictitious patient history. Three clinicians were asked to complete modification for a PTB socket with suspension sleeve at weekly intervals over the course of three weeks. Measurements were recorded at landmarks and compared for intra and inter reliability.Results: Clinicians showed high intraclass and interclass correlation (ICC) values with narrow confidence intervals for the tibial tubercle, medial and lateral flares and distal end of the tibia. One clinician demonstrated moderate intra rater reliability for modification over the patellar tendon. All other ICC values for the patellar tendon and fibular head modification were low. Inter rater reliability was not calculated for fibular head and patellar tendon as intra ICC values should be above 0.6.Conclusions: All clinicians showed good consistency at tibial tubercle, distal tibia, medial and lateral flares. Patellar tendon (0.345< ICC < 0.641) and fibular head (0.165< ICC < 0.513) showed poorer consistency and require improvement. LAYMAN’S ABSTRACT Computer aided design (CAD) is now commonly used to create artificial limbs. However, the shape of the amputated limb is captured when the patient is sitting down and therefore requires further adjustment. Modification of the shape is carried out by clinicians using a range on on-screen tools to remove and add material to the virtual model.This study aims to investigate the consistency of clinicians when making these modifications. A range of 13 below the knee amputation models were made, each linked to a made-up patient history. Three clinicians were asked to randomly complete modification three times on each model at weekly intervals over the course of three weeks. Measurements were recorded at landmarks and compared.Clinicians showed high reliability values for most landmark positions. However, modification was less reliable over important areas such as the patellar tendon and fibular head. Errors in such areas could potentially cause discomfort to the artificial limb wearer and greater consistency is required. This is only an initial study and further work is required to confirm results. ARTICLE PDF LINK: https://jps.library.utoronto.ca/index.php/cpoj/article/view/30006/22878 How to cite: O'Byrne M, McFadyen A K, Hannett D, McGarry A. Measurement of The Consistency of Patella-Tendon-Bearing Modification Using CAD. Canadian Prosthetics & Orthotics Journal, Volume 1, Issue 1, No 2, 2018. DOI: https://doi.org/10.33137/cpoj.v1i1.30006
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.015 | 0.021 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
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 source (direct Gemma or distilled Codex), 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".