Department of Orthopaedics, University Medical Center Utrecht, HP G05.228, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.
Department of Orthopaedics, Erasmus Medical Center, Rotterdam, The Netherlands.
Eur Spine J. 2020 Oct;29(10):2550-2559. doi: 10.1007/s00586-020-06518-0. Epub 2020 Jul 6.
To report on the development of AOSpine CROST (Clinician Reported Outcome Spine Trauma) and results of an initial reliability study.
The AOSpine CROST was developed using an iterative approach of multiple cycles of development, review, and revision including an expert clinician panel. Subsequently, a reliability study was performed among an expert panel who were provided with 20 spine trauma cases, administered twice with 4-week interval. The results of the developmental process were analyzed using descriptive statistics, the reliability per parameter using Kappa statistics, inter-rater rater agreement using intraclass correlation coefficient (ICC), and internal consistency using Cronbach's α.
The AOSpine CROST was developed and consisted of 10 parameters, 2 of which are only applicable for surgically treated patents ('Wound healing' and 'Implants'). A dichotomous scoring system ('yes' or 'no' response) was incorporated to express expected problems for the short term and long term. In the reliability study, 16 (84.2%) participated in the first round and 14 (73.7%) in the second. Intra-rater reliability was fair to good for both time points (κ = 0.40-0.80 and κ = 0.31-0.67). Results of inter-rater reliability were lower (κ = 0.18-0.60 and κ = 0.16-0.46). Inter-rater agreement for total scores showed moderate results (ICC = 0.52-0.60), and the internal consistency was acceptable (α = 0.76-0.82).
The AOSpine CROST, an outcome tool for the surgeons, was developed using an iterative process. An initial reliability analysis showed fair to moderate results and acceptable internal consistency. Further clinical validation studies will be performed to further validate the tool.
报告 AOSpine CROST（临床医生报告的脊柱创伤结果）的制定过程和初步可靠性研究的结果。
AOSpine CROST 是通过多次开发、审查和修订周期的迭代方法制定的，包括一个专家临床医生小组。随后，对一个专家小组进行了可靠性研究，他们提供了 20 例脊柱创伤病例，每 4 周进行两次测试。使用描述性统计、每个参数的 Kappa 统计、组内相关系数（ICC）的组间评分者一致性和 Cronbach's α 的内部一致性来分析发展过程的结果。
AOSpine CROST 已开发完成，包括 10 个参数，其中 2 个仅适用于手术治疗患者（“伤口愈合”和“植入物”）。采用二分制评分系统（“是”或“否”响应）来表示短期和长期的预期问题。在可靠性研究中，16 名（84.2%）参加了第一轮，14 名（73.7%）参加了第二轮。两轮的组内评分者可靠性均为中等至良好（κ=0.40-0.80 和 κ=0.31-0.67）。组间评分者可靠性结果较低（κ=0.18-0.60 和 κ=0.16-0.46）。总评分的组间评分者一致性显示为中等结果（ICC=0.52-0.60），内部一致性可接受（α=0.76-0.82）。
AOSpine CROST 是一种针对外科医生的结果工具，它是使用迭代过程开发的。初步可靠性分析显示出中等至良好的结果和可接受的内部一致性。将进一步进行临床验证研究，以进一步验证该工具。
