Meriqui Roberto, Masuda Rodrigo Yuzo, Utino Artur Yudi, Pierami Rafael, Matsunaga Fábio Teruo, Tamaoki Marcel Jun Sugawara
. Universidade Federal de São Paulo, Escola Paulista de Medicina, Department of Orthopedics and Traumatology, Shoulder and Elbow Orthopedics Division, São Paulo, SP, Brazil.
Acta Ortop Bras. 2017 Jul-Aug;25(4):159-161. doi: 10.1590/1413-785220172504169249.
The objective of this study was to compare inter- and intra-observer agreement using the Garnavos and AO/ASIF systems for classifying humeral diaphysis fractures .
Eighty X-ray images taken of humeral diaphysis fractures in adult patients (age≥18 years) between January 2013 and September 2015 in the Radiology Department of Hospital São Paulo were selected for subsequent classification by five orthopedic surgeons with differing levels of experience. The images were examined at two different times and reproducibility analysis was evaluated using Fleiss' kappa to verify intra- and inter-observer agreement .
High-level agreement was observed for both classification systems, but particularly for the AO/ASIF classification. Inter-observer evaluation yielded excellent levels of agreement for both classifications, but principally for the Garnavos classification .
Good or excellent inter- and intra-observer agreement was seen for both the AO/ASIF and Garnavos classification systems. However, intra-observer agreement was higher for the AO/ASIF system and inter-observer agreement was higher for the Garnavos classification. Level of Evidence II, Diagnostic Studies - Investigating a Diagnostic Examination.
本研究的目的是比较使用加纳沃斯（Garnavos）系统和AO/ASIF系统对肱骨干骨折进行分类时观察者间和观察者内的一致性。
选取2013年1月至2015年9月在圣保罗医院放射科拍摄的80例成年患者（年龄≥18岁）肱骨干骨折的X线图像，由5名经验水平不同的骨科医生进行后续分类。在两个不同时间对图像进行检查，并使用弗莱iss卡方检验评估再现性分析，以验证观察者内和观察者间的一致性。
两种分类系统均观察到高度一致性，但AO/ASIF分类尤为明显。观察者间评估在两种分类中均产生了极好的一致性水平，但主要是在加纳沃斯分类中。
AO/ASIF和加纳沃斯分类系统在观察者间和观察者内均显示出良好或极好的一致性。然而，AO/ASIF系统的观察者内一致性更高，加纳沃斯分类的观察者间一致性更高。证据等级II，诊断研究 - 调查诊断检查。
