Effect of surgical experience and spine subspecialty on the reliability of the AO Spine Upper Cervical Injury Classification System
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Effect of surgical experience and spine subspecialty on the reliability of the AO Spine Upper Cervical Injury Classification System. / Lambrechts, Mark J; Schroeder, Gregory D; Karamian, Brian A; Canseco, Jose A; Oner, F Cumhur; Benneker, Lorin M; Bransford, Richard J; Kandziora, Frank; Rajasekaran, Shanmuganathan; El-Sharkawi, Mohammad; Kanna, Rishi; Joaquim, Andrei Fernandes; Schnake, Klaus; Kepler, Christopher K; Vaccaro, Alexander R; AO Spine Upper Cervical Injury Classification International Members.
in: J NEUROSURG-SPINE, Jahrgang 38, Nr. 1, 01.01.2023, S. 31-41.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Effect of surgical experience and spine subspecialty on the reliability of the AO Spine Upper Cervical Injury Classification System
AU - Lambrechts, Mark J
AU - Schroeder, Gregory D
AU - Karamian, Brian A
AU - Canseco, Jose A
AU - Oner, F Cumhur
AU - Benneker, Lorin M
AU - Bransford, Richard J
AU - Kandziora, Frank
AU - Rajasekaran, Shanmuganathan
AU - El-Sharkawi, Mohammad
AU - Kanna, Rishi
AU - Joaquim, Andrei Fernandes
AU - Schnake, Klaus
AU - Kepler, Christopher K
AU - Vaccaro, Alexander R
AU - AO Spine Upper Cervical Injury Classification International Members
AU - Heuer, Annika
PY - 2023/1/1
Y1 - 2023/1/1
N2 - OBJECTIVE: The objective of this paper was to determine the interobserver reliability and intraobserver reproducibility of the AO Spine Upper Cervical Injury Classification System based on surgeon experience (< 5 years, 5-10 years, 10-20 years, and > 20 years) and surgical subspecialty (orthopedic spine surgery, neurosurgery, and "other" surgery).METHODS: A total of 11,601 assessments of upper cervical spine injuries were evaluated based on the AO Spine Upper Cervical Injury Classification System. Reliability and reproducibility scores were obtained twice, with a 3-week time interval. Descriptive statistics were utilized to examine the percentage of accurately classified injuries, and Pearson's chi-square or Fisher's exact test was used to screen for potentially relevant differences between study participants. Kappa coefficients (κ) determined the interobserver reliability and intraobserver reproducibility.RESULTS: The intraobserver reproducibility was substantial for surgeon experience level (< 5 years: 0.74 vs 5-10 years: 0.69 vs 10-20 years: 0.69 vs > 20 years: 0.70) and surgical subspecialty (orthopedic spine: 0.71 vs neurosurgery: 0.69 vs other: 0.68). Furthermore, the interobserver reliability was substantial for all surgical experience groups on assessment 1 (< 5 years: 0.67 vs 5-10 years: 0.62 vs 10-20 years: 0.61 vs > 20 years: 0.62), and only surgeons with > 20 years of experience did not have substantial reliability on assessment 2 (< 5 years: 0.62 vs 5-10 years: 0.61 vs 10-20 years: 0.61 vs > 20 years: 0.59). Orthopedic spine surgeons and neurosurgeons had substantial intraobserver reproducibility on both assessment 1 (0.64 vs 0.63) and assessment 2 (0.62 vs 0.63), while other surgeons had moderate reliability on assessment 1 (0.43) and fair reliability on assessment 2 (0.36).CONCLUSIONS: The international reliability and reproducibility scores for the AO Spine Upper Cervical Injury Classification System demonstrated substantial intraobserver reproducibility and interobserver reliability regardless of surgical experience and spine subspecialty. These results support the global application of this classification system.
AB - OBJECTIVE: The objective of this paper was to determine the interobserver reliability and intraobserver reproducibility of the AO Spine Upper Cervical Injury Classification System based on surgeon experience (< 5 years, 5-10 years, 10-20 years, and > 20 years) and surgical subspecialty (orthopedic spine surgery, neurosurgery, and "other" surgery).METHODS: A total of 11,601 assessments of upper cervical spine injuries were evaluated based on the AO Spine Upper Cervical Injury Classification System. Reliability and reproducibility scores were obtained twice, with a 3-week time interval. Descriptive statistics were utilized to examine the percentage of accurately classified injuries, and Pearson's chi-square or Fisher's exact test was used to screen for potentially relevant differences between study participants. Kappa coefficients (κ) determined the interobserver reliability and intraobserver reproducibility.RESULTS: The intraobserver reproducibility was substantial for surgeon experience level (< 5 years: 0.74 vs 5-10 years: 0.69 vs 10-20 years: 0.69 vs > 20 years: 0.70) and surgical subspecialty (orthopedic spine: 0.71 vs neurosurgery: 0.69 vs other: 0.68). Furthermore, the interobserver reliability was substantial for all surgical experience groups on assessment 1 (< 5 years: 0.67 vs 5-10 years: 0.62 vs 10-20 years: 0.61 vs > 20 years: 0.62), and only surgeons with > 20 years of experience did not have substantial reliability on assessment 2 (< 5 years: 0.62 vs 5-10 years: 0.61 vs 10-20 years: 0.61 vs > 20 years: 0.59). Orthopedic spine surgeons and neurosurgeons had substantial intraobserver reproducibility on both assessment 1 (0.64 vs 0.63) and assessment 2 (0.62 vs 0.63), while other surgeons had moderate reliability on assessment 1 (0.43) and fair reliability on assessment 2 (0.36).CONCLUSIONS: The international reliability and reproducibility scores for the AO Spine Upper Cervical Injury Classification System demonstrated substantial intraobserver reproducibility and interobserver reliability regardless of surgical experience and spine subspecialty. These results support the global application of this classification system.
KW - Humans
KW - Reproducibility of Results
KW - Observer Variation
KW - Spinal Injuries/diagnosis
KW - Cervical Vertebrae/surgery
KW - Surgeons
U2 - 10.3171/2022.6.SPINE22454
DO - 10.3171/2022.6.SPINE22454
M3 - SCORING: Journal article
C2 - 35986731
VL - 38
SP - 31
EP - 41
JO - J NEUROSURG-SPINE
JF - J NEUROSURG-SPINE
SN - 1547-5654
IS - 1
ER -