Inverting Grayscale Improves Detection of Proximal Femur Fracture

Not Applicable

• Conditions: Diagnoses Disease
• Interventions: Diagnostic Test: BIXAM

• Registration Number: NCT05318378
• Lead Sponsor: Centre de l'arthrose, Paris

Brief Summary

Proximal femur fractures (PFF) are a worldwide public health concern. A delay in the diagnosis and treatment worsens the prognosis. Inversion of grayscale is a tool available on most X-rays visualization software, and its use has been suggested to improve radiological diagnosis. The study aims to determine if using inverted grayscale radiography results in better diagnoses of PFF among medical students.

Material and Methods. The investigators evaluated the detection of PFF by fifth-year medical students on a series of 30 pelvis X-rays. The series was composed of 20 X-rays with PFF and 10 X-rays without fracture. A first reading session was set up where X-rays were presented separately in conventional and inverted grayscale. A second session one month later showed both grayscale visualizations together (BIcontrast X-rays Analysis Method - BIXAM). X-rays' order of appearance was randomized. The investigators performed the same evaluation on senior orthopedic surgeons as a control. Finally, sensitivity, specificity, and accuracy were assessed for each method (conventional, inverted, and BIXAM) with the McNemar test. Subgroup analyses were performed on the fracture localization (femoral neck, trochanteric).

Detailed Description

Not available

Study Timeline

• Study Start: 2022-01-31
• Status Verified: 2022-03
• Study First Submitted: 2022-03-30
• Primary Completion: 2022-03-31
• Study First Submitted QC: 2022-04-07
• Last Update Submitted: 2022-04-07
• Study First Posted: 2022-04-08
• Last Update Posted: 2022-04-08
• Study Completion: 2022-04-30

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 20

Inclusion Criteria

• fifth-year medical students

Exclusion Criteria

• other medical students

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
senior surgeon	BIXAM	As controls, we asked 3 independent board-certified orthopedic surgeons to participate in the study following the same conditions as described previously.
student	BIXAM	Twenty fifth-year medical students were asked to participate in the study

Primary Outcome Measures

Name	Time	Method
Sensibility, specificity,	one month	Sensibility, specificity were compared between conventional and inverted grayscales or both images shown together (BIXAM series) with non-parametric McNemar test
accuracy	one month	accuracy was compared between conventional and inverted grayscales or both images shown together (BIXAM series) with non-parametric McNemar test

Trial Locations

Locations (1)

Aphp; 🇫🇷 Paris, France