Quantitative analysis validation for sclerotherapy treatment of lower limb telangiectasias

Matheus Bertanha; Pedro Luciano Mellucci Filho; Caroline Araujo Genka; Paula Angeleli Bueno de Camargo; Vinicius Tadeu Ramos da Silva Grillo; Nathalia Dias Sertório; Lenize da Silva Rodrigues; Marcone Lima Sobreira; Pedro Luiz Toledo de Arruda Lourenção

doi:10.1016/j.jvsv.2023.03.010

Quantitative analysis validation for sclerotherapy treatment of lower limb telangiectasias

J Vasc Surg Venous Lymphat Disord. 2023 Jul;11(4):708-715. doi: 10.1016/j.jvsv.2023.03.010. Epub 2023 Apr 6.

Authors

Matheus Bertanha¹, Pedro Luciano Mellucci Filho², Caroline Araujo Genka², Paula Angeleli Bueno de Camargo², Vinicius Tadeu Ramos da Silva Grillo², Nathalia Dias Sertório², Lenize da Silva Rodrigues², Marcone Lima Sobreira², Pedro Luiz Toledo de Arruda Lourenção²

Affiliations

¹ Department of Surgery and Orthopedics, Sao Paulo State University (UNESP), Botucatu, Sao Paulo, Brazil. Electronic address: matheusbertanha@gmail.com.
² Department of Surgery and Orthopedics, Sao Paulo State University (UNESP), Botucatu, Sao Paulo, Brazil.

PMID: 37030450
DOI: 10.1016/j.jvsv.2023.03.010

Abstract

Background: The evaluation of sclerotherapy efficacy for lower limb telangiectasias, which is the standard treatment for such condition, is commonly assisted by scores based on before and after pictures. This method is marked by its subjectivity, which impairs the precision of studies on the subject, making it unfeasible to evaluate and compare different interventions. We hypothesize that a quantitative method for evaluating the effectiveness of sclerotherapy for lower limb telangiectasias may present more reproducible results. Reliable measurement methods and new technologies may become part of the clinical practice in the near future.

Methods: Before and after treatment photographs were analyzed using a quantitative method and compared with a validated qualitative method based on improvement scores. Reliability analysis of the methods was performed, applying the intraclass correlation coefficient (ICC) and kappa coefficient with quadratic weights (Fleiss Cohen), for analysis of inter-examiner and intra-examiner agreement in both evaluation methods. Convergent validity was evaluated by applying the Spearman test. To assess the applicability of the quantitative scale, the Mann-Whitney test was used.

Results: A better agreement between examiners is shown for the quantitative scale, with a mean kappa of .3986 (.251-.511) for qualitative analysis and a mean kappa of .788 (.655-.918) for quantitative analysis (P < .001 for all examiners). Convergent validity was achieved by correlation coefficients of .572 to .905 (P < .001). The quantitative scale results obtained between the specialists with different degrees of experience did not show statistical difference (seniors: 0.71 [-0.48/1.00] × juniors: 0.73 [-0.34/1.00]; P = .221).

Conclusions: Convergent validity between both analyses has been achieved, but quantitative analysis has been shown to be more reliable and can be applied by professionals of any degree of experience. The validation of quantitative analysis is a major milestone for the development of new technology and automated, reliable, applications.

Keywords: Computer-assisted; Evaluation methodology; Image processing; Sclerotherapy; Telangiectasias; Validation Study; Veins.

MeSH terms

Humans
Lower Extremity
Reproducibility of Results
Sclerotherapy* / adverse effects
Telangiectasis* / diagnosis
Telangiectasis* / therapy