AO Spine-DGOU Osteoporotic Fracture Classification System: Internal Validation by the AO Spine Knowledge Forum Trauma

Study DesignCross-sectional survey.ObjectivesInjury classifications are important tools to identify fracture patterns, guide treatment-decisions and aid to identify optimal treatment plans. The AO Spine-DGOU Osteoporotic Fracture (OF) classification system was developed, and the aim of this study was to assess the reliability of this new classification system.Methods23 Members of the AO Spine Knowledge Forum Trauma participated in the validation process. Participants were asked to rate 33 cases according to the OF classification at 2 time points, 4 weeks apart (assessment 1 and 2). The kappa statistic (κ) was calculated to assess inter-observer reliability and intra-rater reproducibility. The gold master key for each case was determined by approval of at least 5 out of 7 members of the DGOU.ResultsA total of 1386 ratings (21 raters) were performed. The overall inter-rater agreement was moderate with a combined kappa statistic for the OF classification of 0.496 in assessment 1 and 0.482 in assessment 2. The combined percentage of correct ratings (compared to gold-standard) in assessment 1 was 71.4% and 67.4% in assessment 2. The average intra-rater reproducibility was substantial (κ = 0.74, median 0.76, range 0.55 to 1.00, SD 0.13) for the assessed fracture types.ConclusionsThe assessed overall inter-rater reliability was moderate and substantial in some instances. The average intra-rater reproducibility is substantial. It seems that appropriate training of the classification system can enhance inter- and intra-rater reliability.

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Publication Details

Journal
Global Spine Journal
Published
2024-09-27
DOI
https://doi.org/10.1177/21925682241288187
Citations
7
Primary Topic
Spinal Fractures and Fixation Techniques
Type
article
Field-Weighted Citation Impact
4.01

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article

AO Spine-DGOU Osteoporotic Fracture Classification System: Internal Validation by the AO Spine Knowledge Forum Trauma

Alexander Richard Vaccaro, Mohamed M. Aly, Ratko Yurac, Harvinder Singh Chhabra et al.
7 citations
Global Spine Journal
Spinal Fractures and Fixation Techniques
4.01
article

AO Spine-DGOU Osteoporotic Fracture Classification System: Internal Validation by the AO Spine Knowledge Forum Trauma

Alexander Richard Vaccaro, Mohamed M. Aly, Ratko Yurac, Harvinder Singh Chhabra, José A. Canseco, Eugen Cezar Popescu, Richard Jackson Bransford, Marko H. Neva, Andrei Fernandes Joaquim, Julian Scherer, Ulrich Spiegl, Masahiko Takahata, Rishi Mugesh Kanna, Klaus John Schnake, Mohammad Mostafa El-Sharkawi, F. Cumhur Öner, Frank Kandziora, Gastón Camino-Willhuber, Lorin Michael Benneker
article en
7 citations

Abstract

Study DesignCross-sectional survey.ObjectivesInjury classifications are important tools to identify fracture patterns, guide treatment-decisions and aid to identify optimal treatment plans. The AO Spine-DGOU Osteoporotic Fracture (OF) classification system was developed, and the aim of this study was to assess the reliability of this new classification system.Methods23 Members of the AO Spine Knowledge Forum Trauma participated in the validation process. Participants were asked to rate 33 cases according to the OF classification at 2 time points, 4 weeks apart (assessment 1 and 2). The kappa statistic (κ) was calculated to assess inter-observer reliability and intra-rater reproducibility. The gold master key for each case was determined by approval of at least 5 out of 7 members of the DGOU.ResultsA total of 1386 ratings (21 raters) were performed. The overall inter-rater agreement was moderate with a combined kappa statistic for the OF classification of 0.496 in assessment 1 and 0.482 in assessment 2. The combined percentage of correct ratings (compared to gold-standard) in assessment 1 was 71.4% and 67.4% in assessment 2. The average intra-rater reproducibility was substantial (κ = 0.74, median 0.76, range 0.55 to 1.00, SD 0.13) for the assessed fracture types.ConclusionsThe assessed overall inter-rater reliability was moderate and substantial in some instances. The average intra-rater reproducibility is substantial. It seems that appropriate training of the classification system can enhance inter- and intra-rater reliability.

Global Spine JournalVol. 15(4)
University of Bern (CH), Mahatma Gandhi Medical College and Research Institute (IN), Universidad del Desarrollo (CL), University of Cape Town (ZA), Mansoura University (EG), Universidade Estadual de Campinas (UNICAMP) (BR), University of Washington (US), Thomas Jefferson University Hospital (US), Clinical Emergency Hospital Bucharest (RO), Clínica Alemana (CL), Harborview Medical Center (US), University Medical Center (US), Schön Klinik München Harlaching (DE), University Hospital of Zurich (CH), University Hospital and Clinics (US), Prince Mohammed bin Abdulaziz Hospital (SA), Malteser Waldkrankenhaus Erlangen (DE), Paracelsus Medizinische Privatuniversität (DE), Policlínica Gipuzkoa (ES), Tampere University Hospital (FI), München Klinik Harlaching (DE), Tampere University (FI), Klinik Sonnenhof (CH), Rothman Institute (US), Ganga Hospital (IN), Gulu Hospital (UG), Berufsgenossenschaftliche Unfallklinik Frankfurt am Main (DE), Universidad del Desarrollo del Estado de Puebla (MX), Dokkyo Medical University (JP), Assiut University (EG)
AO Foundation
Good health and well-being
Openalex Percentile: Top 6%
Spinal Fractures and Fixation Techniques
4.01
DOIOpen Access PDFOpenAlex
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