Three-dimensional imaging core laboratory of the endovascular aneurysm repair trials: validation of methodology

OBJECTIVE: The aim of this study was to establish and validate a three-dimensional imaging protocol for the assessment of Computed Tomography (CT) scans of abdominal aortic aneurysms in UK EVAR trials patients. Quality control and repeatability of anatomical measurements is important for the validity of any core laboratory. METHODS: Three different observers performed anatomical measurements on 50 preoperative CT scans of aortic aneurysms using the Vitrea 2 three-dimensional post-imaging software in a core laboratory setting. We assessed the accuracy of intra and inter observer repeatability of measurements, the time required for collection of measurements, 3 different levels of automation and 3 different automated criteria for measurement of neck length. RESULTS: None of the automated neck length measurements demonstrated sufficient accuracy and it was necessary to perform checking of the important automated landmarks. Good intra and limited inter observer agreement were achieved with three-dimensional assessment. Complete assessment of the aneurysm and iliacs took an average (SD) of 17.2 (4.1) minutes. CONCLUSIONS: Aortic aneurysm anatomy can be assessed reliably and quickly using three-dimensional assessment but for scans of limited quality, manual checking of important landmarks remains necessary. Using a set protocol, agreement between observers is satisfactory but not as good as within observers.

Analysis and interpretation of cost data in randomised controlled trials: review of published studies

Objective To review critically the statistical methods used for health economic evaluations in randomised controlled trials where an estimate of cost is available for each patient in the study.

The queer folk of Fife; tales from the Kingdom,

The breach of promise.--Her dead self.--God's own scholar.--The gentleman tramp.--The one fatal mistake.--A romance of the harvest field.--The boy heretic.--How the deacon became an abstainer.

The land of promise, a comedy in four acts,

Mode of access: Internet.

The land of promise : a novelization of W. Somerset Maugham's play /

Mode of access: Internet.

State trials : specimen of a new edition /

In verse.

The bow of promise : an address, delivered before the New York Marine Temperance Society, at the erection of a new flag, on the anniversary of American Independence, July 4th, 1840 /

Mode of access: Internet.