Garbuz Donald S, Masri Bassam A, Esdaile John, Duncan Clive P
Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada.
J Am Acad Orthop Surg. 2002 Jul-Aug;10(4):290-7. doi: 10.5435/00124635-200207000-00007.
Classification systems help orthopaedic surgeons characterize a problem, suggest a potential prognosis, and offer guidance in determining the optimal treatment method for a particular condition. Classification systems also play a key role in the reporting of clinical and epidemiologic data, allowing uniform comparison and documentation of like conditions. A useful classification system is reliable and valid. Although the measurement of validity is often difficult and sometimes impractical, reliability-as summarized by intraobserver and interobserver reliability-is easy to measure and should serve as a minimum standard for validation. Reliability is measured by the kappa value, which distinguishes true agreement of various observations from agreement due to chance alone. Some commonly used classifications of musculoskeletal conditions have not proved to be reliable when critically evaluated.
分类系统有助于骨科医生描述问题、预测潜在预后，并为确定特定病情的最佳治疗方法提供指导。分类系统在临床和流行病学数据报告中也起着关键作用，可实现同类病情的统一比较和记录。一个有用的分类系统应具备可靠性和有效性。虽然有效性的衡量往往困难且有时不切实际，但观察者内和观察者间的可靠性所总结的可靠性易于测量，应作为验证的最低标准。可靠性通过kappa值来衡量，该值可区分各种观察结果的真实一致性与仅因偶然因素导致的一致性。一些常用的肌肉骨骼疾病分类在严格评估时并未被证明是可靠的。
