Penteado Fernando Travaglini, Dos Santos João Baptista Gomes, Caporrino Fábio Augusto, de Moraes Vinícius Ynoe, Belloti João Carlos, Faloppa Flávio
Escola Paulista de Medicina-Universidade Federal de São Paulo-UNIFESP-EPM-Hand and upper limb surgery division, São Paulo, SP Brazil.
J Hand Microsurg. 2012 Jun;4(1):12-5. doi: 10.1007/s12593-012-0062-2. Epub 2012 Apr 14.
Watson & Ballet and Vender staging systems are widely known for classifying SNAC wrist osteoarthritis. Despite of its day-to-day use, no assessment for its agreement was performed. To Evaluate the intra and interobserver agreement for these classification systems. Forty-eight posteroanterior wrist radiographs from patients with osteoarthritis due to scaphoid nonunion were evaluated at two occasions-in a 1 week interval-by five observers with different expertise-hand surgeons, hand surgery residents, orthopedic surgeons and orthopedic surgery residents. They rated osteoarthritis stages according to the above-cited systems. Kappa statistics were performed for measuring agreement. Unsatisfactory (Cohen's Kappa <0.5) agreement was found for all intra and inter observer measures for both systems. There was no clear correlation between expertise and kappa values. Unsatisfactory agreement was found for both classifications, despite the evaluator expertise. A rationale of a more reliable classification is needed.
沃森和巴莱分期系统以及文德分期系统在舟月骨不连性关节炎（SNAC腕）的分类方面广为人知。尽管其日常使用广泛，但尚未对其一致性进行评估。目的是评估这些分类系统在观察者内部和观察者之间的一致性。五名具有不同专业背景的观察者——手外科医生、手外科住院医师、骨科医生和骨外科住院医师，在一周的间隔内分两次对48例因舟骨不连导致骨关节炎患者的腕关节后前位X线片进行了评估。他们根据上述系统对骨关节炎阶段进行评分。采用kappa统计量来衡量一致性。结果发现，两种系统在观察者内部和观察者之间的所有测量中一致性均不理想（科恩kappa系数<0.5）。专业知识与kappa值之间没有明显的相关性。尽管评估者具有专业知识，但两种分类的一致性均不理想。需要一种更可靠的分类依据。
