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  1. Article ; Online: CORR Insights®: Does Flexion Varus Osteotomy Improve Radiographic Findings Compared With Patients Treated in a Brace for Late-onset Legg-Calvé-Perthes Disease?

    Liu, Raymond W

    Clinical orthopaedics and related research

    2022  Volume 481, Issue 4, Page(s) 820–821

    MeSH term(s) Humans ; Legg-Calve-Perthes Disease/diagnostic imaging ; Legg-Calve-Perthes Disease/surgery ; Treatment Outcome ; Follow-Up Studies ; Osteotomy ; Braces
    Language English
    Publishing date 2022-11-23
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 80301-7
    ISSN 1528-1132 ; 0009-921X
    ISSN (online) 1528-1132
    ISSN 0009-921X
    DOI 10.1097/CORR.0000000000002502
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  2. Article ; Online: CORR Insights®: What Factors Correlate With Length of Stay and Readmission After Limb Lengthening Procedures? A Large-database Study.

    Liu, Raymond W

    Clinical orthopaedics and related research

    2022  Volume 480, Issue 9, Page(s) 1764–1765

    MeSH term(s) Bone Lengthening ; Databases, Factual ; Humans ; Length of Stay ; Patient Readmission ; Retrospective Studies
    Language English
    Publishing date 2022-05-17
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 80301-7
    ISSN 1528-1132 ; 0009-921X
    ISSN (online) 1528-1132
    ISSN 0009-921X
    DOI 10.1097/CORR.0000000000002250
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  3. Article ; Online: The Value of Interventional Radiology: An Imperative to Understand Costs.

    Liu, Raymond

    Journal of vascular and interventional radiology : JVIR

    2021  Volume 32, Issue 4, Page(s) 614–615

    MeSH term(s) Costs and Cost Analysis ; Humans ; Radiology, Interventional
    Language English
    Publishing date 2021-02-12
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 1137756-2
    ISSN 1535-7732 ; 1051-0443
    ISSN (online) 1535-7732
    ISSN 1051-0443
    DOI 10.1016/j.jvir.2020.10.032
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    Zs.A 3720: Show issues Location:
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  4. Article ; Online: The Addition of Hand-specific Skeletal Maturity Parameters Does Not Improve Skeletal Maturity Estimation Accuracy of the Modified Fels Wrist System.

    Sinkler, Margaret A / Furdock, Ryan J / Halloran, Sean / Liu, Raymond W

    Journal of pediatric orthopedics

    2024  Volume 44, Issue 4, Page(s) 281–285

    Abstract: Background: The Modified Fels Wrist system is potentially the most accurate clinically accessible skeletal maturity system utilizing hand or wrist radiographs. During development, parameters distal to the metacarpals were excluded. We attempted to ... ...

    Abstract Background: The Modified Fels Wrist system is potentially the most accurate clinically accessible skeletal maturity system utilizing hand or wrist radiographs. During development, parameters distal to the metacarpals were excluded. We attempted to further optimize the Modified Fels wrist system through the inclusion of hand parameters distal to the metacarpals.
    Methods: Forty-three new anteroposterior (AP) hand radiographic parameters were identified from the Fels and Greulich and Pyle (GP) skeletal maturity systems. Twelve parameters were eliminated from further evaluation for poor correlation with skeletal maturity, poor reliability, and lack of relevance in the peripubertal years. In addition to the 8 previously described Modified Fels Wrist parameters, 31 hand radiographic parameters were evaluated on serial peripubertal AP hand radiographs to identify the ones most important for accurately estimating skeletal age. This process produced a "Modified Fels hand-wrist" model; its performance was compared with (1) GP only; (2) Sanders Hand (SH) only; (3) age, sex, and GP; (4) age, sex, and SH; and (5) Modified Fels Wrist system.
    Results: Three hundred seventy-two radiographs from 42 girls and 38 boys were included. Of the 39 radiographic parameters that underwent full evaluation, 9 remained in the combined Modified Fels Hand-Wrist system in addition to chronological age and sex. Four parameters are wrist specific, and the remaining 5 are hand specific. The Hand-Wrist system outperformed both GP and SH in estimating skeletal maturity ( P <0.001). When compared with the Modified Fels Wrist system, the Modified Fels Hand-Wrist system performed similarly regarding skeletal maturity estimation (0.36±0.32 vs. 0.34±0.26, P =0.59) but had an increased (worse) rate of outlier predictions >1 year discrepant from true skeletal maturity (4.9% vs. 1.9%, P =0.01).
    Conclusions: The addition of hand parameters to the existing Modified Fels Wrist system did not improve skeletal maturity estimation accuracy and worsened the rate of outlier estimations. When an AP hand-wrist radiograph is available, the existing Modified Fels wrist system is best for skeletal maturity estimation.
    Level of evidence: Level III.
    MeSH term(s) Male ; Female ; Humans ; Wrist/diagnostic imaging ; Reproducibility of Results ; Age Determination by Skeleton ; Hand/diagnostic imaging ; Wrist Joint/diagnostic imaging
    Language English
    Publishing date 2024-01-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 604642-3
    ISSN 1539-2570 ; 0271-6798
    ISSN (online) 1539-2570
    ISSN 0271-6798
    DOI 10.1097/BPO.0000000000002621
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    Zs.A 1681: Show issues Location:
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  5. Article: Correlation between Femoral Neck Version, Sagittal Femoral Bowing Angle and Sagittal Offset of the Femoral Head from the Distal Femur Axis in an Osteological Collection.

    Ho, Dedi / Liu, Raymond W / McClure, Philip K

    Strategies in trauma and limb reconstruction

    2023  Volume 18, Issue 1, Page(s) 12–15

    Abstract: Aim: Radiographic analysis of lower limb alignment is crucial for the planning and evaluation of deformity correction. Assessment in the sagittal plane is often overlooked compared with the coronal plane for a variety of reasons. We aimed to investigate ...

    Abstract Aim: Radiographic analysis of lower limb alignment is crucial for the planning and evaluation of deformity correction. Assessment in the sagittal plane is often overlooked compared with the coronal plane for a variety of reasons. We aimed to investigate the relationship between the femoral head in the sagittal plane and femoral neck version in the axial plane, and how sagittal femoral bowing angle (sFBA) may contribute.
    Materials and methods: Twenty-five each of high (1-2 standard deviations above mean), normal (2.5° below to 2.5° above the mean), and low (1-2 standard deviations below the mean) version femurs were randomly selected from an osteological collection database, photographed and measured for sFBA and sagittal offset of femoral head from the distal femur axis. Lines were drawn within the proximal and distal quartiles of the shaft to create sFBA. The offset of the distal quartile line and the femoral head was also measured. High intra- and inter-observer correlations were established. The relationship between parameters was assessed using the Pearson coefficient (
    Results: Sagittal offset of the femoral head from the distal femur axis was found to be highly correlated with sFBA (
    Conclusions: Neither the sFBA nor sagittal femoral head offset is strongly associated with femoral neck version.
    Clinical significance: Our data reinforce the need for long leg lateral films to include the femoral head in sagittal deformity analysis, as imaging limited to the knee will not account for the effect of bowing on femoral head position.
    How to cite this article: Ho D, Liu RW, Mcclure PK. Correlation between Femoral Neck Version, Sagittal Femoral Bowing Angle and Sagittal Offset of the Femoral Head from the Distal Femur Axis in an Osteological Collection. Strategies Trauma Limb Reconstr 2023;18(1):12-15.
    Language English
    Publishing date 2023-09-12
    Publishing country India
    Document type Journal Article
    ZDB-ID 2387508-2
    ISSN 1828-8928 ; 1828-8936
    ISSN (online) 1828-8928
    ISSN 1828-8936
    DOI 10.5005/jp-journals-10080-1577
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Comparison of pelvic incidence measurement using lateral x-ray, standard ct versus ct with 3d reconstruction.

    Lee, Carol M / Liu, Raymond W

    European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

    2021  Volume 31, Issue 2, Page(s) 241–247

    Abstract: Purpose: Pelvic incidence (PI) is a position independent parameter used to quantify spinopelvic sagittal balance. PI is generally measured on lateral radiographs, but more recent studies have suggested better accuracy with standard CT scans versus three- ...

    Abstract Purpose: Pelvic incidence (PI) is a position independent parameter used to quantify spinopelvic sagittal balance. PI is generally measured on lateral radiographs, but more recent studies have suggested better accuracy with standard CT scans versus three-dimensional (3D) CT scans. This study compares PI obtained from lateral XR, standard CT scan and CT scan with 3D reconstruction.
    Methods: A total of 77 subjects with lateral XRs of the pelvis or lumbosacral spine and CT scans of the pelvis were randomly selected. Pelvic incidence on lateral XRs, standard CT scans and CT scans utilizing multiplanar reconstruction were measured and compared using intraclass correlation coefficients (ICC). PI was also measured on serial images in 28 individuals using the same imaging modality within 3 years and evaluated using ICC.
    Results: Mean ± SD of PI measurements on XR, standard CT and CT with 3D reconstruction were 56° ± 13°, 53° ± 12° and 53° ± 12°, respectively, demonstrating a small but significant elevation of PI measurement on XR (P < 0.001). ICC values demonstrated a higher correlation between standard CT and 3D CT (ICC 0.986), compared to XR and standard CT (ICC 0.934) and XR and 3D CT (ICC 0.937). PI measurements on repeated imaging of the same individual also demonstrated that both CT methods produced more consistent measurements (ICC 0.986 for standard CT, 0.981 for 3D CT, 0.935 for XR).
    Conclusion: Although standard XR does provide a high level of reliability, it appears to slightly overestimate PI. CT scans do provide increased reliability, with no additional benefit of 3D reconstructions over standard CT.
    MeSH term(s) Humans ; Imaging, Three-Dimensional/methods ; Radiography ; Reproducibility of Results ; Tomography, X-Ray Computed/methods ; X-Rays
    Language English
    Publishing date 2021-11-06
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1115375-1
    ISSN 1432-0932 ; 0940-6719
    ISSN (online) 1432-0932
    ISSN 0940-6719
    DOI 10.1007/s00586-021-07024-7
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    Zs.A 3437: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
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  7. Article ; Online: Developmental Anatomy of the Radial Bow in Pediatric Patients using 3D Imaging.

    Nedder, Victoria J / Chen, Kallie J / May, Catherine C / Abzug, Joshua M / Liu, Raymond W

    Journal of pediatric orthopedics

    2024  

    Abstract: Background: While radial bow shape is well characterized in adults, its development in children is not well understood. Previous studies on the radial bow use radiographs, thus, rotational positioning of the forearm could alter bowing measurements. This ...

    Abstract Background: While radial bow shape is well characterized in adults, its development in children is not well understood. Previous studies on the radial bow use radiographs, thus, rotational positioning of the forearm could alter bowing measurements. This study used 3D imaging to better assess the pediatric radial bow.
    Methods: Computed tomography scans from the New Mexico Decedent Image Database were obtained for ages 2 to 16 (females) and 18 (males) (n=152). 3D models were generated using Slicer and Rhino software. Length of the entire radial bow (bicipital tuberosity to sigmoid notch), maximum radial bow, location of the maximum radial bow (bicipital tuberosity to the point of maximum bowing), and distal, middle, and proximal third radial bows were measured.
    Results: The length of the entire bow increased with age, with a strong correlation with age (r=0.90, P<0.01). The maximum bow increased with age, with a strong correlation with age (r=0.78, P<0.01). The maximum bow normalized to the length of the entire bow increased mildly with age, mean 0.059 ± 0.012 (r=0.24, P=0.0024), but seems to plateau around age 8. The location of the maximum bow increased with age (r=0.85, P<0.01). The normalized location of the maximum bow remained constant between ages, with a mean of 0.41 ± 0.10 (r=0.12, P=0.14). The normalized distal third bow mildly increased with age (r=0.34, P<0.01), the normalized middle third bow mildly increased with age (r=0.25, P<0.01), and the normalized proximal third bow remained constant between ages (r=0.096, P=0.24).
    Conclusions: Normalized values for maximum, distal third, and middle third radial bow increase with age, while normalized values for location and proximal third radial bow remain relatively constant, suggesting the proportional shape of the radius changes during development, although qualitatively plateaus after age 8.
    Level of evidence: Retrospective comparative study, Level-III.
    Language English
    Publishing date 2024-02-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 604642-3
    ISSN 1539-2570 ; 0271-6798
    ISSN (online) 1539-2570
    ISSN 0271-6798
    DOI 10.1097/BPO.0000000000002645
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  8. Article ; Online: A Claims-Based Method for Identification and Characterization of Practicing Interventional Radiologists.

    Waid, Mikki D / Rula, Elizabeth Y / Hawkins, C Matthew / Findeiss, Laura / Liu, Raymond

    Journal of vascular and interventional radiology : JVIR

    2024  

    Abstract: Purpose: To propose a research method for identifying "practicing interventional radiologists" using 2 national claims data sets.: Materials and methods: The 2015-2019 100% Medicare Part B data and 2015-2019 private insurance claims from Optum's ... ...

    Abstract Purpose: To propose a research method for identifying "practicing interventional radiologists" using 2 national claims data sets.
    Materials and methods: The 2015-2019 100% Medicare Part B data and 2015-2019 private insurance claims from Optum's Clinformatics Data Mart (CDM) database were used to rank-order radiologists' interventional radiology (IR)-related work as a percentage of total billed work relative value units (RVUs). Characteristics were analyzed at various threshold percentages. External validation used Medicare self-designated specialty with Society of Interventional Radiology (SIR) membership records; Youden index evaluated sensitivity and specificity. Multivariate logistic regression assessed practicing IR characteristics.
    Results: In the Medicare data, above a 10% IR-related work threshold, only 23.8% of selected practicing interventional radiologists were designated as interventional radiologists; above 50% and 90% thresholds, this percentage increased to 42.0% and 47.5%, respectively. The mean percentage of IR-related work among practicing interventional radiologists was 45%, 84%, and 96% of total work RVUs for the 10%, 50%, and 90% thresholds, respectively. At these thresholds, the CDM practicing interventional radiologists included 21.2%, 35.2%, and 38.4% designated interventional radiologists, and evaluation and management services comprised relatively more total work RVUs. Practicing interventional radiologists were more likely to be males, metropolitan, and earlier in their careers than other radiologists at all thresholds.
    Conclusions: Most radiologists performing IR-related work are designated in claims data as diagnostic radiologists, indicating insufficiency of specialty designation for IR identification. The proposed method to identify practicing interventional radiologists by percent IR-related work effort could improve generalizability and comparability across claims-based IR studies.
    Language English
    Publishing date 2024-03-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1137756-2
    ISSN 1535-7732 ; 1051-0443
    ISSN (online) 1535-7732
    ISSN 1051-0443
    DOI 10.1016/j.jvir.2024.02.020
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    Zs.A 3720: Show issues Location:
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  9. Article ; Online: Revisiting the Association of ECOG Performance Status With Clinical Outcomes in Diverse Patients With Cancer.

    Kumar, Deepika / Neeman, Elad / Zhu, Shiyun / Sun, Hongxin / Kotak, Dinesh / Liu, Raymond

    Journal of the National Comprehensive Cancer Network : JNCCN

    2024  , Page(s) 1–7

    Abstract: Background: The ECOG performance status (PS) scale was developed to support national clinical trials, but the degree to which ECOG PS predicts clinical outcomes in patient subgroups outside of clinical trials is relatively unknown. This study examined ... ...

    Abstract Background: The ECOG performance status (PS) scale was developed to support national clinical trials, but the degree to which ECOG PS predicts clinical outcomes in patient subgroups outside of clinical trials is relatively unknown. This study examined associations between ECOG PS and adverse outcomes in a diverse community oncology population.
    Patients and methods: In this retrospective cohort study, demographic and clinical characteristics, including the most recent ECOG PS between January 1, 2017, and December 31, 2019, were examined for patients receiving cancer treatment within Kaiser Permanente Northern California (KPNC). Proportional hazard models were used to evaluate the effect of ECOG PS on adverse outcomes.
    Results: A total of 21,730 patients were identified. Overall, most patients had an ECOG PS of 0 (42.5%) or 1 (42.5%). In multivariable analysis, an ECOG PS of 3 or 4 was associated with higher risk of 30-day emergency department visits (adjusted hazard ratio [aHR], 3.85; 95% CI, 3.47-4.26), 30-day hospitalizations (aHR, 4.70; 95% CI, 4.12-5.36), and 6-month mortality (aHR, 7.34; 95% CI, 6.64-8.11) compared with an ECOG PS of 0. Additionally, we found that upper gastrointestinal and stage IV cancers were associated with a higher risk of adverse outcomes compared with breast and stage I cancers, respectively. When adjusted for ECOG PS, African American race, Asian race, and female sex were associated with a lower risk of mortality than White race and male sex. An ECOG PS of 3 or 4 was more predictive of mortality in younger patients and those with breast cancer (P<.001).
    Conclusions: ECOG PS and upper gastrointestinal and stage IV cancers were independently associated with increased risk of emergency department visits, hospitalizations, and mortality, whereas African American and Asian race and female sex were associated with decreased risk of mortality. An ECOG PS of 3 or 4 was more predictive of an increased risk of mortality in younger patients and patients with breast cancer. These findings can enhance the use of ECOG PS for clinical decision-making and defining eligibility for clinical trials.
    Language English
    Publishing date 2024-04-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2250759-0
    ISSN 1540-1413 ; 1540-1405
    ISSN (online) 1540-1413
    ISSN 1540-1405
    DOI 10.6004/jnccn.2023.7111
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  10. Article: The Relationship Between Height and Income With Potential Application to Treatment of Limb Length Discrepancy.

    Rascoe, Alexander S / Peng, Eric J / Ferrell, Dre'Marcus / Copp, Jonathan A / Liu, Raymond W

    Cureus

    2024  Volume 16, Issue 3, Page(s) e56331

    Abstract: Purpose When treating limb length discrepancy (LLD), decisions regarding lengthening versus contralateral shortening require careful consideration of deformity and patient factors. Using the National Longitudinal Survey of Youth 1979 (NLSY79) database, ... ...

    Abstract Purpose When treating limb length discrepancy (LLD), decisions regarding lengthening versus contralateral shortening require careful consideration of deformity and patient factors. Using the National Longitudinal Survey of Youth 1979 (NLSY79) database, and income as a quantitative representation of overall socioeconomic benefit, we sought to determine the height at which incremental gains in height have the greatest value. Methods Using the NLSY79 database, we collected demographic data, height, yearly income from wages, college education (full- or part-time), and receipt of government financial aid. Multiple-linear regression and graphical analysis were performed. Results The study population included 9,652 individuals, 4,775 (49.5%) males and 4,877 (50.5%) females. Mean heights were 70.0±3.0 inches and 64.3±2.6 inches for males and females, respectively. Multiple-linear regression analysis (adjusted-r²=0.33) demonstrated height had a standardized-ß=0.097 (p<0.001), even when accounting for confounding factors. Using graphical analysis, we estimated cut-offs of 74 inches for males and 69 inches for females, beyond which income decreased with incremental height. Conclusions Using income as a quantitative representation of socioeconomic value, our analysis found income increased with incremental height in individuals with predicted heights up to 74 inches for males and 69 inches for females. Shortening procedures might receive more consideration at predicted heights greater than these cut-offs, while lengthening might be more strongly considered at the lower ranges of height. Additionally, our multiple-linear regression analysis confirms the correlation between height and income, when factoring in other predictors of income.
    Language English
    Publishing date 2024-03-17
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.56331
    Database MEDical Literature Analysis and Retrieval System OnLINE

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