Grin Andrey, Lvov Ivan, Talypov Aleksandr, Kordonskiy Anton, Khushnazarov Ulugbek, Krylov Vladimir
Department of Neurosurgery, Sklifosovsky Research Institute for Emergency Medicine, Moscow, Russia; Department of Neurosurgery, Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia.
Department of Neurosurgery, Sklifosovsky Research Institute for Emergency Medicine, Moscow, Russia.
Neurocirugia (Engl Ed). 2023 Mar-Apr;34(2):80-86. doi: 10.1016/j.neucie.2022.02.010. Epub 2023 Feb 6.
To compare the teachability of the Allen-Ferguson, Harris, Argenson, AOSpine, Subaxial Cervical Spine Injury Classification (SLIC), Subaxial Cervical Spine Injury Classification (CSISS) and to identify the classification that a group of residents and junior neurosurgeons find easiest to learn.
We used data from 64 consecutive patients. Answers of nine residents and junior neurosurgeons and four experienced surgeons in two assessment procedures were used. Six raters (workshop group) participated in special seminars between assessments. Three other raters formed the control group. Experienced surgeon's answers were used for comparison. Teachability was measured as the median value of the difference (ΔK) in the interrater agreement on the same patients by the same pairs of subjects.
Median Δ K for the Allen-Ferguson, Harris, Argenson and AOSpine classifications were: (1) 0.01, 0.02, 0.29, and 0.39 for the workshop group; (2). 0.09, -0.03, 0.06 and 0.04 for the control group, respectively. Between numerical scales, median ΔK was higher for SLIC but did not exceed 0.16. Interrater consistency with expert's opinion was increased in the workshop group for Allen-Ferguson, Argenson and AOSpine and did not differ in either group for SLIC and CSISS.
The AOSpine classification was the most teachable. Among numeric scales, SLIC demonstrated better results. The successful application of these classifications by residents and junior neurosurgeons was possible after a short educational course. The use of these scales in educational cycles at the stage of residency can significantly simplify the communication between specialists, especially at the stage of patient admission.
比较艾伦 - 弗格森（Allen-Ferguson）、哈里斯（Harris）、阿格森（Argenson）、AO脊柱、下颈椎损伤分类（SLIC）、下颈椎损伤分类（CSISS）的可教授性，并确定一组住院医师和初级神经外科医生认为最容易学习的分类方法。
我们使用了连续64例患者的数据。采用了9名住院医师和初级神经外科医生以及4名经验丰富的外科医生在两种评估程序中的答案。6名评分者（研讨会组）在评估之间参加了特别研讨会。另外3名评分者组成对照组。使用经验丰富的外科医生的答案进行比较。可教授性通过同一组受试者对同一患者的评分者间一致性差异（ΔK）的中位数来衡量。
艾伦 - 弗格森、哈里斯、阿格森和AO脊柱分类的ΔK中位数分别为：（1）研讨会组为0.01、0.02、0.29和0.39；（2）对照组分别为0.09、-0.03、0.06和0.04。在数字量表之间，SLIC的ΔK中位数较高，但不超过0.16。研讨会组中，艾伦 - 弗格森、阿格森和AO脊柱分类与专家意见的评分者间一致性有所提高，而SLIC和CSISS在两组中无差异。
AO脊柱分类是最易于教授的。在数字量表中，SLIC表现出更好的结果。经过短期教育课程后，住院医师和初级神经外科医生能够成功应用这些分类方法。在住院医师阶段的教育周期中使用这些量表可以显著简化专家之间的沟通，尤其是在患者入院阶段。
