Clinical Focus

  • Physical Medicine and Rehab

Academic Appointments

Professional Education

  • Residency: Stanford University Physical Medicine and Rehabiliation (2024) CA
  • Internship: University of Missouri Kansas City School of Medicine (2021) MO
  • Medical Education: Kansas City University of Medicine and Biosciences (2020) MO

Contact

  • Academic
    dschirm@stanford.edu
    University - Academic staff Department: Orthopaedic Surgery Position: Clinical Instructor
  • Clinical (Primary)  Stanford Ortho Spine Center 420 Broadway St Pavilion D MC 6415 Redwood City, CA 94063 (650) 721-3409 (fax)

Additional Clinical Info

Additional Info

  • Mail Code: 6342

All Publications

  • The Interrater Reliability of Modic Changes among a Potential Basivertebral Nerve Ablation Population: Why AC1 may be preferred to Kappa. Journal of orthopaedic research : official publication of the Orthopaedic Research Society Sherwood, D., Sterling Haring, R., Schirmer, D., Modic, M. 2022

    Abstract

    Interrater reliability of Modic changes is subject to variables which affect consistency in reporting. Given the importance of Modic change identification for basivertebral nerve ablation candidacy, interrater reliability for this specific cohort has not yet been reported. Twenty lumbar magnetic resonance images of potential basivertebral nerve candidates were independently reviewed by two neuroradiologists and two interventional spine physiatrists for the presence and characterization of Modic changes. The kappa value of their agreement on the presence of Modic changes was 0.52 (95% CI 0.37 - 0.67) whereas agreement on the type of Modic change was 0.51 (95% CI 0.37 - 0.65). Using an alternative methodology for measuring interrater reliability (Gwet's AC1) yielded the identification of the presence of Modic changes at AC1 0.51 (95% CI 0.36 - 0.66), whereas agreement on the type of Modic change was AC1 0.75 (95% CI 0.66 - 0.83). While less common, AC1 may be preferred in the appropriate cohort to Kappa as it mitigates some of the pitfalls to which Kappa values may be victim. Ultimately, our results are in-line with previous reports of interrater reliability results for Modic changes in other cohorts and should serve to caution those who preform basivertebral nerve ablation regarding interrater agreement of the imaging crux of the procedure. This article is protected by copyright. All rights reserved.

    View details for DOI 10.1002/jor.25449

    View details for PubMedID 36200411