Department of Radiology, Valencian Oncology Institute Foundation, Valencia, Spain; Research Institute in Health Services Foundation, Valencia, Spain; Spanish Back Pain Research Network, Kovacs Foundation, Palma de Mallorca, Spain.
Spanish Back Pain Research Network, Kovacs Foundation, Palma de Mallorca, Spain; Scientific Department, Kovacs Foundation, Palma de Mallorca, Spain.
Radiother Oncol. 2015 Apr;115(1):135-40. doi: 10.1016/j.radonc.2015.03.016. Epub 2015 Apr 10.
To assess variability in the use of Tomita and modified Bauer scores in spine metastases.
Clinical data and imaging from 90 patients with biopsy-proven spinal metastases, were provided to 83 specialists from 44 hospitals. Spinal levels involved and the Tomita and modified Bauer scores for each case were determined twice by each clinician, with a minimum of 6-week interval. Clinicians were blinded to every evaluation. Kappa statistic was used to assess intra and inter-observer agreement. Subgroup analyses were performed according to clinicians' specialty (medical oncology, neurosurgery, radiology, orthopedic surgery and radiation oncology), years of experience (⩽7, 8-13, ⩾14), and type of hospital (four levels).
For metastases identification, intra-observer agreement was "substantial" (0.60<k<0.80) at sacrum, and "almost perfect" (k>0.80) at the other levels. Inter-observer agreement was "almost perfect" at lumbar spine, and "substantial" at the other levels. Intra-observer agreement for the Tomita and Bauer scores was almost perfect. Inter-observer agreement was almost perfect for the Tomita score and substantial for the Bauer one. Results were similar across specialties, years of experience and type of hospital.
Agreement in the assessment of metastatic spine disease is high. These scoring systems can improve communication among clinicians involved in oncology care.
评估 Tomita 和改良 Bauer 评分在脊柱转移瘤中的应用变异性。
为 44 家医院的 83 名专家提供了 90 例经活检证实的脊柱转移瘤患者的临床数据和影像学资料。每位临床医生两次确定受累脊柱节段和每个病例的 Tomita 和改良 Bauer 评分，两次间隔至少 6 周。临床医生对每个评估均不知情。kappa 统计用于评估内部和外部观察者之间的一致性。根据临床医生的专业（肿瘤内科、神经外科、放射科、骨科和放射肿瘤科）、经验年限（⩽7 年、8-13 年、⩾14 年）和医院类型（四级）进行亚组分析。
对于转移瘤的识别，在骶骨处，内部观察者之间的一致性为“中等”（0.60<k<0.80），而在其他部位则为“近乎完美”（k>0.80）。腰椎处的外部观察者之间的一致性为“近乎完美”，而在其他部位则为“中等”。Tomita 和 Bauer 评分的内部观察者之间的一致性几乎是完美的。Tomita 评分的外部观察者之间的一致性几乎是完美的，而 Bauer 评分的外部观察者之间的一致性则是中等的。在不同专业、经验年限和医院类型中，结果相似。
评估转移性脊柱疾病的一致性很高。这些评分系统可以提高参与肿瘤治疗的临床医生之间的沟通。
