ZHANG Kuibo,LIU Hui,WANG Jianru.Reliability and reproducibility analysis of clinical and radiographic degenerative spondylolisthesis classification[J].Chinese Journal of Spine and Spinal Cord,2014,(8):729-733.
Reliability and reproducibility analysis of clinical and radiographic degenerative spondylolisthesis classification
Received:June 20, 2014  Revised:July 27, 2014
English Keywords:Lumbar spondylolisthesis  Degeneration  Classification  Reliability  Reproducibility
Fund:广东省自然科学基金博士启动项目(编号:S2011040002494)
Author NameAffiliation
ZHANG Kuibo Department of Orthopedics, the Fifth Hospital of Sun Yat-sen University, Zhuhai, 519000, China 
LIU Hui 中山大学附属第一医院脊柱外科 510080 广州市 
WANG Jianru 中山大学附属第一医院脊柱外科 510080 广州市 
李思贝  
陈 涛  
李国威  
黄宗文  
郑召民  
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English Abstract:
  【Abstract】 Objectives: To investigate the inter-observer reliability and intra-observer reproducibility of the clinical and radiographic degenerative spondylolisthesis(CARDS) classification system for degenerative spondylolisthesis and its clinical values. Methods: From January 2010 to December 2013, 49 patients with degenerative spondylolisthesis were treated in our department. Based on the CARDS classification system, the radiographs were assessed by five observers independently on two separate occasions with an interval of 1 month. The inter-observer reliability and intra-observer reproducibility of the system were quantified by using Kappa value and Spearman correlation coefficient. Results: The total 490 classifications were evaluated for two times. Fifteen percent(74 cases) were described as type A; thirty-four percent(167 cases), as type B; thirty-eight percent(187 cases), as type C and thirteen percent(62 cases), as type D. The inter-observer reliability assessed by the mean percentage and Kappa values at the first time was 77.6%-93.9%(89.6%), 0.764 respectively for disc space; 69.4%-91.8%(86.6%), 0.719 respectively for kyphosis; 67.3%-81.6%(77.5%), 0.596 respectively for translation; 65.3%-81.6%(74.1%), 0.641 respectively for final classification. The Spearman correlation coefficient was 0.564, 0.612, 0.576 and 0.589, respectively. The intra-observer reproducibility assessed by the mean percentage and Kappa values was 85.7%-98.0%(94.7%), 0.857 respectively for disc space; 89.8%-95.9%(92.1%), 0.842 respectively for kyphosis; 77.6%-91.8%(87.5%), 0.779 respectively for translation;75.5%-87.8%(82.4%), 0.804 respectively for final classification. The Spearman correlation coefficient was 0.714, 0.702, 0.689 and 0.645, respectively. Conclusions: The CARDS classification system for degenerative spondylolisthesis has good inter-observer reliability and excellent intra-observer reproducibility.
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