A Novel Tool for Collaborative and Blinded Orthopedic Image Analysis

Abstract

Image analysis plays a central role in orthopedics and research but comes with many challenges, including anonymization, bias, and achieving efficient analyses using multiple independent observers. Appropriate software is still lacking. Tyche is a free online tool that displays images in a random order without showing any metadata. Additionally, when using Tyche, observers can store results in the same window, and the final results are immediately visible to the project manager. In this study, we compared results from Tyche with those from a validated tool. One hundred pelvic radiographs were analyzed separately by five orthopedic surgeons using both Tyche and the validated software. Common orthopedic measurement modalities and scores were determined. The methods were compared using intra-class correlations and Fleiss’ kappa coefficients as well as Bland–Altman plots. Significant correlations ranging from r = 0.17 (Kallgren and Lawrence Score) to r = 0.99 (area measurements) were calculated for inter- and intraobserver agreements between the two tools for all measurements. The Bland–Altman plots indicated the non-inferiority of either tool. The images were analyzed significantly faster when Tyche was used. We conclude that Tyche is a valid tool for use in orthopedic image analysis. Tyche could be utilized for determining inter- and intraobserver agreements, in multicenter studies and for score validations.

Reliability of Angle Measurements Based on the Epiphyseal Scar for Knee Osteotomy: An International Multicenter Radiographic Study

“…The online tool Tyche ® (Philipp Schippers) was utilized to facilitate a multicenter study and obtain objective measurement results. 14 , 24 , 25 , 28 Fully anonymized images were temporarily uploaded to Tyche, where only dedicated observers had temporary access with encrypted connections. Observers analyzed the images blinded and in random order inside a web browser; they were provided with standard imaging tools (eg, pan, zoom, and contrast) and angle tools (eg, standard angle, Cobb angle).…”

A Lightweight Browser-Based Tool for Collaborative and Blinded Image Analysis

“…Machado et al, Micicoi et al, and Schippers et al have already used it on small series (<200 images) for orthopedic measurements [38][39][40]. In addition, with the single-choice question format, Tyche can be efficiently used to score images, like in a study by Schippers et al, which applied the Kallgren and Lawrence score to more than one hundred pelvic X-rays [41]. Thus, it can be used to determine an existing score on a set of images or validate a new score, as Schippers et al did to apply a new scoring system for toe alignment in foot surgery [42].…”