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  3. Effect of surgical experience and spine subspecialty on the reliability of the AO Spine Upper Cervical Injury Classification System.
 

Effect of surgical experience and spine subspecialty on the reliability of the AO Spine Upper Cervical Injury Classification System.

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BORIS DOI
10.48350/172285
Publisher DOI
10.3171/2022.6.SPINE22454
PubMed ID
35986731
Description
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.
Date of Publication
2023-01-01
Publication Type
Article
Subject(s)
600 - Technology::610 - Medicine & health
Keyword(s)
AO Spine neurosurgeon orthopedic spine surgeon reliability reproducibility trauma upper cervical spine
Language(s)
en
Contributor(s)
Lambrechts, Mark J
Schroeder, Gregory D
Karamian, Brian A
Canseco, Jose A
Oner, F Cumhur
Benneker, Lorin Michael
Universitätsklinik für Orthopädische Chirurgie und Traumatologie
Bransford, Richard J
Kandziora, Frank
Rajasekaran, Shanmuganathan
El-Sharkawi, Mohammad
Kanna, Rishi
Joaquim, Andrei Fernandes
Schnake, Klaus
Kepler, Christopher K
Vaccaro, Alexander R
Additional Credits
Universitätsklinik für Orthopädische Chirurgie und Traumatologie
Series
Journal of neurosurgery - spine
Publisher
American Association of Neurological Surgeons
ISSN
1547-5654
Access(Rights)
open.access
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