Comparison of Reliability of AO/ASIF and Evan’s Classifications
Authors:
Radoslav Morochovič 1; Dana Potočeková 2; Henrieta Blašková 3; Ivan Bugáň 1
Authors‘ workplace:
Department of Trauma Surgery, School of Medicine, University of P. J. Šafárik and FNLP, Košice
1; Klinika úrazovej chirurgie LF UPJŠ a FNLP, Košice
1; Institute of Medical Informatics, School of Medicine, University of P. J. Šafárik, Košice
2; Ústav lekárskej informatiky LF UPJŠ, Košice
2; Department of Radiodiagnostics and Nuclear Medicine, FNLP, Košice
3; Klinika rádiodiagnostiky a nukleárnej medicíny FNLP, Košice
3
Published in:
Úraz chir. 16., 2008, č.1
Overview
Purpose of the study:
There are many of classification systems for grading trochanteric fractures. Of these the AO/ASIF and Evan’s classification systems are widely used. To be a beneficial tool for indicating a method of treatment or permitting communication between surgeons, the classification system should be reliable and reproducible. The aim of this study was to compare the interobserver reliability and intraobserver reproducibility of the AO/ASIF and Evan’s classifications.
Material and Methods:
Plain preoperative and the first postoperative radiographs of 39 consecutive series of patients were classified using the AO/ASIF (with and without subgroups) and Evan’s classifications by five observers (2 ex-perienced surgeons, an experienced radiologist and 2 medical students). The same radiographs were classified by the same observers three months later. Observers agreement was assessed with the weighed coefficient kappa (κ).
Results:
The mean kappa (κ) value for interobserver reliability was 0.43 with the AO/ASIF subgroups (31 A1.1-A3.3), 0.51 with the AO/ASIF main groups (31A1-A3), and 0.37 with Evan’s classification. The mean κ value for intraobserver reproducibility was 0.50, 0.53 and 0.42 respectively. Perfect agreement of all observations in the first session was obtained 18 times (46%) with the AO/ASIF main groups, twice with the AO/ASIF subgroups (5%), and 5 times (13%) with Evan’s classification and 18 (46%), 2 (5%) and 4 times (10%) in the second session respectively.
Discussion and Conclusions:
Our data confirm outcomes of other authors that both the AO/ASIF and Evan’s classifications have moderate to fair inter- and intraobserver reliability with the best mean kappa values for the classification in the AO/ASIF three main groups. Using of early postoperative radiographs for classification did not increase the accuracy of classifying trochanteric fractures in comparison with other authors’ outcomes.
Key words:
kappa statistics, interobserver reliability, intraobserver reproducibility, trochanteric fractures.
Sources
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Surgery Traumatology Trauma surgeryArticle was published in
Trauma Surgery
2008 Issue 1
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