Independent Reliability Analysis of a New Classification for Pyogenic Spondylodiscitis
Journal
Global Spine Journal
ISSN
2192-5682
2192-5690
Date Issued
2020
Author(s)
Gaston Camino Willhuber
Alfredo Guiroy
Nelson Astur
Marcelo Valacco
Type
Resource Types::text::journal::journal article
URL Institutional Repository
Abstract
<jats:sec><jats:title>Study Design:</jats:title><jats:p> Diagnostic study, level of evidence III. </jats:p></jats:sec><jats:sec><jats:title>Objective:</jats:title><jats:p> Pyogenic spondylodiscitis can cause deformity, neurological compromise, disability, and death. Recently, a new classification of spondylodiscitis based on magnetic resonance imaging was published. The objective of this study is to perform an independent reliability analysis of this new classification. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> We selected 35 cases from our database of different spine centers in Latin America and from the literature; 8 observers evaluated the classification and graded the scenarios according to the methodological grading of the classification developed by Pola et al. Cases were sent to the observers in a random sequence after 3 weeks to assess intraobserver reliability. The interobserver and intraobserver reliabilities were performed with Fleiss and Cohen statistics, respectively. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> The overall Fleiss κ value for interobserver agreement was substantial, with 0.67 (95% CI = 0.43-0.91) in the first reading and 0.67 (95% CI = 0.45-0.89) in second reading for the main types of classification. The Cohen κ value for intraobserver agreement was also substantial, with 0.68 (95% CI = 0.45-0.92). The interobserver agreement analysis for the subtypes of this classification was overall substantial, with 0.60 (95% CI = 0.37-0.83) in the first reading and 0.61 (95% CI = 0.41-0.81) in the second reading. The overall intraobserver agreement for subtypes of the classification was also substantial, with 0.63 (95% CI = 0.34-0.93). </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> The new classification developed by Pola et al showed substantial interobserver and intraobserver agreements. More studies are required to validate the usefulness of this classification especially in clinical practice. </jats:p></jats:sec>
Subjects
disc space infection
;
pyogenic spondylodiscitis
;
spondylodiscitis classification
;
vertebral osteomyelitis
;
algorithm
;
article
;
bone destruction
;
clinical practice
;
deformity
;
disability
;
diskitis
;
human
;
interrater reliability
;
intrarater reliability
;
kyphosis
;
length of stay
;
measurement accuracy
;
morbidity
;
nervous system
;
nuclear magnetic resonance imaging
;
osteomyelitis
;
practice guideline
;
prospective study
;
reliability
;
scoring system
;
spine surgery
;
spondylolisthesis