Gaston Camino-Willhuber1, Byron Delgado2, Nelson Astur3,4, Alfredo Guiroy5, Marcelo Valacco6, Luigi Aurelio Nasto7, Luca Piccone8, Giovanni Barbanti-Brodano9, Antonio Leone10, Valerio Cipolloni11, Enrico Pola12, Julio Urrutia13. 1. Orthopaedic and Traumatology Department, Institute of Orthopedics "Carlos E. Ottolenghi" Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. 2. Department of Orthopedic Surgery, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile. 3. Santa Casa de Misericordia de San Pablo, São Paulo, Brazil. 4. Hospital Israelita Albert Einstein, Morumbi, São Paulo, Brazil. 5. Orthopedic Department, Spine Unit, Hospital Español de Mendoza, Mendoza, Argentina. 6. Hospital Churruca Visca, Buenos Aires, Argentina. 7. Department of Orthopaedics and Traumatology, Policlinico di Napoli University Hospital, Università della Campania "Luigi Vanvitelli", Naples, Italy. 8. Department of Orthopaedics and Traumatology, A. Gemelli University Hospital Foundation IRCCS, Catholic University, Rome, Italy. 9. Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy. 10. Department of Radiology, A. Gemelli University Hospital Foundation IRCCS, Catholic University, Rome, Italy. 11. Department of Orthopaedic, A. Gemelli University Hospital Foundation IRCCS, Catholic University, Rome, Italy. 12. Division of Spine Surgery, Department of Orthopaedics and Traumatology, Policlinico Di Napoli University Hospital, Università Della Campania "Luigi Vanvitelli", Naples, Italy. 13. Department of Orthopedic Surgery, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile. jurrutia@med.puc.cl.
Abstract
PURPOSE: Pola et al. described a clinical-radiological classification of pyogenic spinal infections (PSI) based on magnetic resonance imaging (MRI) features including vertebral destruction, soft tissue involvement, and epidural abscess, along with the neurological status. We performed an inter- and intra-observer agreement evaluation of this classification. METHODS: Complete MRI studies of 80 patients with PSI were selected and classified using the scheme described by Pola et al. by seven evaluators. After a four-week interval, all cases were presented to the same assessors in a random sequence for repeat assessment. We used the weighted kappa statistics (wκ) to establish the inter- and intra-observer agreement. RESULTS: The inter-observer agreement was substantial considering the main categories (wκ = 0.77; 0.71-0.82), but moderate considering the subtypes (wκ = 0.51; 0.45-0.58). The intra-observer agreement was substantial considering the main types (wκ = 0.65; 0.59-0.71), and moderate considering the subtypes (wκ = 0.58; 0.54-0.63). CONCLUSION: The agreement at the main type level indicates that this classification allows adequate communication and may be used in clinical practice; at the subtypes level, the agreement is only moderate.
PURPOSE: Pola et al. described a clinical-radiological classification of pyogenic spinal infections (PSI) based on magnetic resonance imaging (MRI) features including vertebral destruction, soft tissue involvement, and epidural abscess, along with the neurological status. We performed an inter- and intra-observer agreement evaluation of this classification. METHODS: Complete MRI studies of 80 patients with PSI were selected and classified using the scheme described by Pola et al. by seven evaluators. After a four-week interval, all cases were presented to the same assessors in a random sequence for repeat assessment. We used the weighted kappa statistics (wκ) to establish the inter- and intra-observer agreement. RESULTS: The inter-observer agreement was substantial considering the main categories (wκ = 0.77; 0.71-0.82), but moderate considering the subtypes (wκ = 0.51; 0.45-0.58). The intra-observer agreement was substantial considering the main types (wκ = 0.65; 0.59-0.71), and moderate considering the subtypes (wκ = 0.58; 0.54-0.63). CONCLUSION: The agreement at the main type level indicates that this classification allows adequate communication and may be used in clinical practice; at the subtypes level, the agreement is only moderate.
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