Evaluation of intra- and interobserver reliability of the AO classification for wrist fractures

Abstract

ObjectiveThis study evaluated the intraobserver and interobserver reliability of the AO classification for standard radiographs of wrist fractures.MethodsThirty observers, divided into three groups (orthopedic surgery senior residents, orthopedic surgeons, and hand surgeons) classified 52 wrist fractures, using only simple radiographs. After a period of four weeks, the same observers evaluated the initial 52 radiographs, in a randomized order. The agreement among the observers, the groups, and intraobserver was obtained using the Kappa index. Kappa-values were interpreted as proposed by Landis and Koch.ResultsThe global interobserver agreement level of the AO classification was considered fair (0.30). The three groups presented fair global interobserver agreement (residents, 0.27; orthopedic surgeons, 0.30; hand surgeons, 0.33). The global intraobserver agreement level was moderated. The hand surgeon group obtained the higher intraobserver agreement level, although only moderate (0.50). The residents group obtained fair levels (0.30), as did the orthopedics surgeon group (0.33).ConclusionThe data obtained suggests fair levels of interobserver agreement and moderate levels of intraobserver agreement for the AO classification for wrist fractures.

Fratura Do Rádio Distal: Avaliação Da Concordância Das Classificações Ao, Frikman E Universal Entre Preceptores E Residentes De Ortopedia E Traumatologia Do Honpar

“…É de grande importância uma boa confiabilidade inter observador para uma classificação, já que uma classificação adequada é essencial para definirmos a gravidade da lesão e servir como base na escolha da conduta terapêutica, avaliar resultados e prognósticos (TENÓRIO et al, 2018).…”

“…Vários autores tentaram classificar as fraturas do terço distal do rádio, entretanto, nenhuma classificação é totalmente aceita, por não possuir elementos suficientes que orientem o tratamento, bem como o prognóstico dessas fraturas (LUCENA, 2015;TENÓRIO et al, 2018).…”

Avaliação da reprodutibilidade intra- e interobservador da nova classificação AO/OTA para fraturas distais do rádio comparada com a classificação de Fernandez

“…The second is used to evaluate the agreement between the observers and involves adjusting the observed proportion of agreement by correcting the proportion of agreement that arises in each case. 1 7 17 23 …”

“…O segundo avalia a concordância entre os observadores e envolve o ajuste da proporção observada de concordância pela correção da proporção de concordância que surge em cada caso. 1 7 17 23 …”

“…The second is used to evaluate the agreement between the observers and involves adjusting the observed proportion of agreement by correcting the proportion of agreement that arises in each case. 1,7,17,23 The calculation of kappa indexes was performed in Online Kappa Calculator (Justus Randolph) with data analysis using free-marginal kappa, since the evaluators remained free to choose the answers. 20 Traditionally, the kappa coefficient values, interpreted by Landis et al, range from 0 to 1, with 1 being equal to perfect agreement and 0 corresponding to no agreement, as specified in ►Table 1.…”