Brady O H, Garbuz D S, Masri B A, Duncan C P
Department of Orthopaedics, University of British Columbia, Vancouver, Canada.
J Arthroplasty. 2000 Jan;15(1):59-62. doi: 10.1016/s0883-5403(00)91181-1.
This study assessed the reliability and validity of a new classification system for fractures of the femur after hip arthroplasty. Forty radiographs were evaluated by 6 observers, 3 experts and 3 nonexperts. Each observer read the radiographs on 2 separate occasions and classified each case as to its type (A, B, C) and subtype (B1, B2, B3). Reliability was assessed by looking at the intraobserver and interobserver agreement using the kappa statistic. Validity was assessed within the B group by looking at the agreement between the radiographic classification and the intraoperative findings. Our findings suggest that this classification system is reliable and valid. Intraobserver agreement was consistent across observers, ranging from 0.73 to 0.83. There was a negligible difference between experts and nonexperts. Interobserver agreement was 0.61 for the first reading and 0.64 for the second reading by kappa analysis, indicating substantial agreement between observers. Validity analysis revealed an observed agreement kappa value of 0.78, indicating substantial agreement. This study has shown that this classification is reliable and valid.
本研究评估了一种用于髋关节置换术后股骨骨折的新分类系统的可靠性和有效性。6名观察者（3名专家和3名非专家）对40张X光片进行了评估。每位观察者在两个不同的时间阅读这些X光片，并将每个病例按其类型（A、B、C）和亚型（B1、B2、B3）进行分类。通过使用kappa统计量观察观察者内和观察者间的一致性来评估可靠性。通过观察X光片分类与术中发现之间的一致性，在B组内评估有效性。我们的研究结果表明，该分类系统是可靠且有效的。观察者内一致性在各观察者之间是一致的，范围从0.73到0.83。专家和非专家之间的差异可以忽略不计。通过kappa分析，观察者间一致性在第一次阅读时为0.61，第二次阅读时为0.64，表明观察者之间有实质性的一致性。有效性分析显示观察到的一致性kappa值为0.78，表明有实质性的一致性。本研究表明该分类是可靠且有效的。
