Assessment of Inter- and Intra-Rater Reliability of Tablet-Based Software to Measure Cochlear Duct Length

Objective: The objective of this study is to build upon previous work validating a tablet-based software to measure cochlear duct length (CDL). Here, we do so by greatly expanding the number of cochleae (n = 166) analyzed, and examined whether computed tomography (CT) slice thickness influences reliability of CDL measurements. Study Design: Retrospective chart review study. Setting: Tertiary referral center. Patients: Eighty-three adult cochlear implant recipients were included in the study. Both cochleae were measured for each patient (n = 166). Interventions: Three raters analyzed the scans of 166 cochleae at 2 different time points. Each rater individually identified anatomical landmarks that delineated the basal turn diameter and width. These coordinates were applied to the elliptic approximation method (ECA) to estimate CDL. The effect of CT scan slice thickness on the measurements was explored. Main Outcome Measures: The primary outcome measure is the strength of the inter- and intra-rater reliability. Results: The mean CDL measured was 32.84 +/- 2.03 mm, with a range of 29.03 to 38.07 mm. We observed no significant relationship between slice thickness and CDL measurement (F1,164 = 3.04; p = 0.08). The mean absolute difference in CDL estimations between raters was 1.76 +/- 1.24 mm and within raters was 0.263 +/- 0.200 mm. The intra-class correlation coefficient (ICC) between raters was 0.54 and ranged from 0.63 to 0.83 within raters. Conclusions: This software produces reliable measurements of CDL between and within raters, regardless of CT scan thickness.