方法:全球横断面调查。
目的:探讨地理区域对AO脊柱骶骨分类系统的影响。
方法:来自6个AO世界地区的158名AO脊柱和AO创伤成员(非洲,亚洲,欧洲,拉丁美洲和南美洲,中东,和北美)参加了现场网络研讨会,以评估可靠性,再现性,使用AO脊柱骶骨分类系统对骶骨骨折进行分类的准确性。对26例以随机顺序出现的病例进行了评估,每次间隔3周。
结果:共进行了8320例病例评估。所有区域都显示出良好的观察者内骨折形态可重复性。来自欧洲(k=.80)和北美(k=.86)的受访者对骨折亚型具有良好的可重复性,而来自所有其他地区的受访者则表现出实质性的可重复性。所有区域在裂缝形态和亚型方面都表现出最低的观察者间可靠性。与黄金标准相比,每个区域在对骨折形态进行分类方面的准确率>90%,在骨折亚型方面的准确率>80%。C型形态(p2=.0000)和A3(p1=.0280),B2(p1=.0015),C0(p1=.0085),和C2(p1=.0016,p2=.0000)亚型在分类精度上显示出显著的区域差异(p1=评估1,p2=评估2)。亚洲受访者(A3除外)和合并后的北方群体,拉丁文,南美的准确度百分比低于综合平均值,而来自欧洲的受访者得分始终高于平均水平。
结论:在AO脊柱骶骨分类系统的全球验证研究中,在所有地理区域都发现了断裂形态和亚型分类的基本可靠性。
METHODS: Global cross-sectional survey.
OBJECTIVE: To explore the influence of geographic region on the AO Spine Sacral Classification System.
METHODS: A total of 158 AO Spine and AO Trauma members from 6 AO world regions (Africa, Asia, Europe, Latin and South America, Middle East, and North America) participated in a live webinar to assess the reliability, reproducibility, and accuracy of classifying sacral fractures using the AO Spine Sacral Classification System. This evaluation was performed with 26 cases presented in randomized order on 2 occasions 3 weeks apart.
RESULTS: A total of 8320 case assessments were performed. All regions demonstrated excellent intraobserver reproducibility for fracture morphology. Respondents from Europe (k = .80) and North America (k = .86) achieved excellent reproducibility for fracture subtype while respondents from all other regions displayed substantial reproducibility. All regions demonstrated at minimum substantial interobserver reliability for fracture morphology and subtype. Each region demonstrated >90% accuracy in classifying fracture morphology and >80% accuracy in fracture subtype compared to the gold standard. Type C morphology (p2 = .0000) and A3 (p1 = .0280), B2 (p1 = .0015), C0 (p1 = .0085), and C2 (p1 =.0016, p2 =.0000) subtypes showed significant regional disparity in classification accuracy (p1 = Assessment 1, p2 = Assessment 2). Respondents from Asia (except in A3) and the combined group of North, Latin, and South America had accuracy percentages below the combined mean, whereas respondents from Europe consistently scored above the mean.
CONCLUSIONS: In a global validation study of the AO Spine Sacral Classification System, substantial reliability of both fracture morphology and subtype classification was found across all geographic regions.