TY - JOUR
T1 - Reliability and Reproducibility of the OTA/AO Classification for Humeral Shaft Fractures
AU - the HUMMER trial investigators
AU - Mahabier, Kiran C.
AU - Van Lieshout, Esther M.M.
AU - Van Der Schaaf, Boyd C.
AU - Roukema, Gert R.
AU - Punt, Bas J.
AU - Verhofstad, Michael H.J.
AU - Den Hartog, Dennis
AU - Bolhuis, Hugo W.
AU - Bos, P. Koen
AU - Bronkhorst, Maarten W.G.A.
AU - Bruijninckx, Milko M.M.
AU - Den Hoed, P. Ted
AU - Dwars, Boudewijn J.
AU - Goslings, J. Carel
AU - Haverlag, Robert
AU - Heetveld, Martin J.
AU - Kerver, Albert J.H.
AU - Kolkman, Karel A.
AU - Leenhouts, Peter A.
AU - Onstenk, Ron
AU - Poeze, Martijn
AU - Poolman, Rudolf W.
AU - Roerdink, W. Herbert
AU - Sintenie, Jan Bernard
AU - Soesman, Nicolaj M.R.
AU - Van Der Heijden, Frank H.W.M.
AU - Van Der Zwaal, Peer
AU - Van Dijk, Jan P.
AU - Van Jonbergen, Hans Peter W.
AU - Verleisdonk, Egbert J.M.M.
AU - Vroemen, Jos P.A.M.
AU - Waleboer, Marco
AU - Zuidema, Wietse P.
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Objectives: This study aimed to determine interobserver reliability and intraobserver reproducibility of the OTA/AO classification for humeral shaft fractures, and to evaluate differences between fracture types, fracture groups, and surgical specializations. Methods: Thirty observers (25 orthopaedic trauma surgeons and 5 general orthopaedic surgeons) independently classified 90 humeral shaft fractures according to the OTA/AO classification. Patients of 16 years and older were included. Periprosthetic, recurrent, and pathological fractures were excluded. Radiographs were provided in random order, and observers were blinded to clinical information. To determine intraobserver agreement, radiographs were reviewed again after 2 months in a different random order. Agreement was assessed using kappa statistics. Results: Interobserver agreement for the 3 fracture types was moderate (κ = 0.60; 0.59-0.61). It was substantial for type A (κ = 0.77; 0.70-0.84) and moderate for type B (κ = 0.52; 0.46-0.58) and type C fractures (κ = 0.46; 0.42-0.50). Interobserver agreement for the 9 fracture groups was moderate (κ = 0.48; 95% CI, 0.48-0.48). Orthopaedic trauma surgeons had better overall agreement for fracture types, and general orthopaedic surgeons had better overall agreement for fracture groups. Observers classified 64% of fractures identically in both rounds. Intraobserver agreement was substantial for the 3 types (κ = 0.80; 0.77-0.81) and 9 groups (κ = 0.80; 0.77-0.82). Intraobserver agreement showed no differences between surgical disciplines. Conclusions: The OTA/AO classification for humeral shaft fractures has a moderate interobserver and substantial intraobserver agreement for fracture types and groups.
AB - Objectives: This study aimed to determine interobserver reliability and intraobserver reproducibility of the OTA/AO classification for humeral shaft fractures, and to evaluate differences between fracture types, fracture groups, and surgical specializations. Methods: Thirty observers (25 orthopaedic trauma surgeons and 5 general orthopaedic surgeons) independently classified 90 humeral shaft fractures according to the OTA/AO classification. Patients of 16 years and older were included. Periprosthetic, recurrent, and pathological fractures were excluded. Radiographs were provided in random order, and observers were blinded to clinical information. To determine intraobserver agreement, radiographs were reviewed again after 2 months in a different random order. Agreement was assessed using kappa statistics. Results: Interobserver agreement for the 3 fracture types was moderate (κ = 0.60; 0.59-0.61). It was substantial for type A (κ = 0.77; 0.70-0.84) and moderate for type B (κ = 0.52; 0.46-0.58) and type C fractures (κ = 0.46; 0.42-0.50). Interobserver agreement for the 9 fracture groups was moderate (κ = 0.48; 95% CI, 0.48-0.48). Orthopaedic trauma surgeons had better overall agreement for fracture types, and general orthopaedic surgeons had better overall agreement for fracture groups. Observers classified 64% of fractures identically in both rounds. Intraobserver agreement was substantial for the 3 types (κ = 0.80; 0.77-0.81) and 9 groups (κ = 0.80; 0.77-0.82). Intraobserver agreement showed no differences between surgical disciplines. Conclusions: The OTA/AO classification for humeral shaft fractures has a moderate interobserver and substantial intraobserver agreement for fracture types and groups.
KW - classification
KW - humeral shaft fracture
KW - interobserver variability
KW - intraobserver variability
KW - observer variation
UR - http://www.scopus.com/inward/record.url?scp=84991458142&partnerID=8YFLogxK
U2 - https://doi.org/10.1097/BOT.0000000000000738
DO - https://doi.org/10.1097/BOT.0000000000000738
M3 - Article
C2 - 27755334
SN - 0890-5339
VL - 31
SP - e75-e80
JO - Journal of Orthopaedic Trauma
JF - Journal of Orthopaedic Trauma
IS - 3
ER -