Universal disease-specific outcome instruments for spine trauma: a global perspective on relevant parameters to evaluate clinical and functional outcomes of thoracic and lumbar spine trauma patients

Sadiqi, Said; Verlaan, Jorrit‐Jan; Lehr, A. Mechteld; Dvorak, Marcel F.; Kandziora, Frank; Rajasekaran, Shanmuganathan; Schnake, Klaus John; Vaccaro, Alexander R.; Öner, F. Cumhur

doi:10.1007/s00586-016-4596-z

Cited by 7 publications

(6 citation statements)

References 23 publications

(19 reference statements)

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“…Also fluency in English was required to complete the surveys. The current survey was combined with two surveys of an AOSpine project that focuses on the development of a surgeon reported outcome instrument for spine trauma patients [20,21].…”

Section: Recruitment Of Participantsmentioning

confidence: 99%

Measurement of kyphosis and vertebral body height loss in traumatic spine fractures: an international study

et al. 2016

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Purpose To investigate whether wide variations are seen in the measurement techniques preferred by spine surgeons around the world to assess traumatic fracture kyphosis and vertebral body height loss (VBHL). Methods An online survey was conducted at two time points among an international community of spine trauma experts from all world regions. The first survey (TL-survey) focused on the thoracic, thoracolumbar and lumbar spine, the second survey (C-survey) on the subaxial cervical spine. Participants were asked to indicate which measurement technique(s) they used for measuring kyphosis and VBHL. Descriptive statistics, frequency analysis and the Fisher exact test were used to analyze the responses.Results Of the 279 invited experts, 107 (38.4 %) participated in the TL-survey, and 108 (38.7 %) in the C-survey. The Cobb angle was the most frequently used for all spine regions to assess kyphosis (55.6-75.7 %), followed by the wedge angle and adjacent endplates method. Concerning VBHL, the majority of the experts used the vertebral body compression ratio in all spine regions (51.4-54.6 %). The most frequently used combination for kyphosis was the Cobb and wedge angles. Considerable differences were observed between the world regions, while fewer differences were seen between surgeons with different degrees of experience. Conclusions This study identified worldwide variations in measurement techniques preferred by treating spine surgeons to assess fracture kyphosis and VBHL in spine trauma patients. These results establish the importance of standardizing assessment parameters in spine trauma care, and can be taken into account to further investigate these radiographic parameters.

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Section: Recruitment Of Participantsmentioning

confidence: 99%

Measurement of kyphosis and vertebral body height loss in traumatic spine fractures: an international study

et al. 2016

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“…The tool was developed in an iterative fashion in several development cycles with sequential reviews and revisions in multiphase processes conducted in expert meetings. First, on the basis of two preparatory studies [8,9], a number of parameters were selected in this process and then refined further. In the developmental process of the AOSpine CROST, multiple versions of the tool including those parameters were pilot tested among several examples of spine trauma cases from the daily clinical practice.…”

Section: Discussionmentioning

confidence: 99%

“…'Wound healing' in surgically treated patient might impact patient care, e.g., in form of revision surgeries or ongoing antibiotic treatment. 'Functional recovery' was added to the clinician's perspectivebased AOSpine CROST tool while not having been evaluated in preparatory studies [8,9]. We felt that this parameter would add a valuable contribution to the overall tool, and provide a direct connection to the patient's reported outcome as expressed by AOSpine PROST (Patient Reported Outcome Spine Trauma).…”

Section: Discussionmentioning

confidence: 99%

“…In the developmental process of the tool, two separate surveys were conducted among international spine trauma experts in order to identify relevant clinical and radiological parameters for the thoracic and lumbar spine [8], and for the cervical spine [9]. Subsequently, integrating evidence from the preparatory studies with expert opinion, a working draft version of the AOSpine CROST was developed.…”

Section: Developmental Process Aospine Crostmentioning

confidence: 99%

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Development and reliability of the AOSpine CROST (Clinician Reported Outcome Spine Trauma): a tool to evaluate and predict outcomes from clinician’s perspective

et al. 2020

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Purpose To report on the development of AOSpine CROST (Clinician Reported Outcome Spine Trauma) and results of an initial reliability study. Methods The AOSpine CROST was developed using an iterative approach of multiple cycles of development, review, and revision including an expert clinician panel. Subsequently, a reliability study was performed among an expert panel who were provided with 20 spine trauma cases, administered twice with 4-week interval. The results of the developmental process were analyzed using descriptive statistics, the reliability per parameter using Kappa statistics, inter-rater rater agreement using intraclass correlation coefficient (ICC), and internal consistency using Cronbach’s α. Results The AOSpine CROST was developed and consisted of 10 parameters, 2 of which are only applicable for surgically treated patents (‘Wound healing’ and ‘Implants’). A dichotomous scoring system (‘yes’ or ‘no’ response) was incorporated to express expected problems for the short term and long term. In the reliability study, 16 (84.2%) participated in the first round and 14 (73.7%) in the second. Intra-rater reliability was fair to good for both time points (κ = 0.40–0.80 and κ = 0.31–0.67). Results of inter-rater reliability were lower (κ = 0.18–0.60 and κ = 0.16–0.46). Inter-rater agreement for total scores showed moderate results (ICC = 0.52–0.60), and the internal consistency was acceptable (α = 0.76–0.82). Conclusions The AOSpine CROST, an outcome tool for the surgeons, was developed using an iterative process. An initial reliability analysis showed fair to moderate results and acceptable internal consistency. Further clinical validation studies will be performed to further validate the tool.

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“…However, the overall concept of the outcome instrument relates more to the functional impairment and the problems in daily living related to this impairment and not to specific treatment strategies such as the use of medication. Opioid use could be taken into account for the AOSpine CROST, the future outcome instrument from the perspective of the treating surgeons [22,23]. The findings obtained from the pilot study are of great value for refining the AOSpine PROST prior to multicenter validation of this instrument.…”

Section: Discussionmentioning

confidence: 99%

Development of the AOSpine Patient Reported Outcome Spine Trauma (AOSpine PROST): a universal disease-specific outcome instrument for individuals with traumatic spinal column injury

et al. 2017

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Purpose To report on the multi-phase process used in developing the AOSpine Patient Reported Outcome Spine Trauma (AOSpine PROST), as well as the results of its application in a pilot study. Methods The International Classification of Functioning, Disability and Health (ICF) methodology was used as the basis for the development of this tool. Four preparatory studies and a consensus conference were performed, and resulted in the selection of 25 core ICF categories as well as the scale for use. The first draft of the Dutch version of AOSpine PROST was pilot tested among a consecutively selected representative sample of 25 spine trauma patients, using the 'think aloud' and 'probing' methods. Results Of the 25 core ICF categories, 9 related to body functions, 14 activities and participation, and 2 environmental factors. Those 25 core categories were implemented into the selected response scale, and resulted in a draft version of AOSpine PROST consisting of 19 items. From the pilot study, very satisfactory results were obtained for comprehensibility, relevance, acceptability, feasibility and completeness, as well as high internal consistency (Cronbach's a = 0.926). Conclusions Following the ICF methodology and including the results of 4 different preparatory studies and a consensus conference, the AOSpine PROST is developed. Taking the results from the subsequent pilot study into account, a definite version to be further validated will be developed. The AOSpine PROST has the potential to be a helpful tool in clinical practice and research to compare various treatments and improve the quality of health care.

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Universal disease-specific outcome instruments for spine trauma: a global perspective on relevant parameters to evaluate clinical and functional outcomes of thoracic and lumbar spine trauma patients

Cited by 7 publications

References 23 publications

Measurement of kyphosis and vertebral body height loss in traumatic spine fractures: an international study

Measurement of kyphosis and vertebral body height loss in traumatic spine fractures: an international study

Development and reliability of the AOSpine CROST (Clinician Reported Outcome Spine Trauma): a tool to evaluate and predict outcomes from clinician’s perspective

Development of the AOSpine Patient Reported Outcome Spine Trauma (AOSpine PROST): a universal disease-specific outcome instrument for individuals with traumatic spinal column injury

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