Suppr超能文献

磁共振矢状位 Ellman 分级系统在部分厚度肩袖撕裂中的可靠性。

Reliability of Ellman Classification System in Partial Thickness Rotator Cuff Tears on Magnetic Resonance Views.

机构信息

Usak University Faculty of Medicine, Department of Orthopaedics and Traumatology, Usak, Turkey.

出版信息

Acta Chir Orthop Traumatol Cech. 2023;90(4):259-266.

Abstract

PURPOSE OF THE STUDY The current study aimed to investigate the intra- and inter-observer reliability of the Ellman classification system in partialthickness rotator cuff tears through magnetic resonance imaging (MRI) scans instead of arthroscopic views. MATERIAL AND METHODS Pre-operative MRI scans of 45 patients, with confirmed partial-thickness rotator cuff rupture in previous arthroscopic surgeries (performed by the senior author), were obtained from Picture Archiving and Communication Systems records. The observers (n=8) were asked to categorize MRI scans according to Ellman's classification of location and grade. There were four orthopedic surgeons less experienced in rotator cuff operations in the first group and four more experienced orthopedic surgeons in the second group. They were asked to re-evaluate the MRI scans six weeks later, without access to their previous answers. Reliability evaluation was performed within and among the groups. It was also evaluated if the surgeon's experience increased the reliability of the classification. Fleiss kappa coefficient was used for the inter-observer reliability and Cohen kappa coefficient for the intra-observer reliability, and post hoc analysis was performed. RESULTS When all observers were examined in the inter-observer evaluation, it was seen that there was moderate agreement in the first location evaluation (κ=0.414); however, there was fair agreement in all other evaluations in both groups (κ=0.339- 0.383-0.337, respectively). When all observers were examined in the mean intra-observer evaluation, it was seen that there was substantial agreement in both evaluations (κ=0.795-0.721, respectively). DISCUSSION A classification system must be valid, reliable, and reproducible. It should establish a standard terminology for both surgeons and researchers. The correct identification of the tear configuration is crucial for selecting the correct repair technique. In our study, in which we evaluated the Ellman classification, which is frequently used in arthroscopic diagnosis, we investigated its intra-observer and inter-observer reliability on MRI scans. Although the mean intra-observer evaluation results were substantial agreement (κ=0.795-0.721, respectively), inter-observer evaluation results were fair agreement (κ=0.339- 0.383-0.337, respectively) except for the first location evaluation (κ=0.414). CONCLUSIONS Although intra-observer reliability was satisfactory, the Ellman system used in the classification of partial-thickness rotator cuff tears was not found to be useful by using only MRI views because of fair inter-observer reliability except for the first location evaluation, which was moderate agreement. Key words: partial, rotator cuff, tear, Ellman classification, reliability, validity.

摘要

目的 本研究旨在通过磁共振成像(MRI)扫描而非关节镜视图,探讨 Ellman 分类系统在部分厚度肩袖撕裂中的内部和观察者间可靠性。

材料和方法 从图片存档和通信系统记录中获取了 45 名先前经关节镜手术(由资深作者进行)证实存在部分厚度肩袖破裂的患者的术前 MRI 扫描。要求观察者(n=8)根据 Ellman 的位置和等级分类对 MRI 扫描进行分类。第一组有 4 名经验较少的关节镜肩袖手术骨科医生,第二组有 4 名经验更丰富的骨科医生。他们被要求在六周后重新评估 MRI 扫描,而不参考他们之前的答案。在组内和组间进行了可靠性评估。还评估了外科医生的经验是否会提高分类的可靠性。采用 Fleiss kappa 系数评估观察者间可靠性,采用 Cohen kappa 系数评估观察者内可靠性,并进行事后分析。

结果 在观察者间评估中,当所有观察者均被检查时,发现第一位置评估存在中度一致性(κ=0.414);然而,在两组中,所有其他评估均存在公平一致性(κ=0.339-0.383-0.337,分别)。当所有观察者均在平均观察者内评估中进行检查时,发现两者的评估均存在实质性一致性(κ=0.795-0.721,分别)。

讨论 分类系统必须有效、可靠且可重复。它应为外科医生和研究人员建立标准的术语。正确识别撕裂形态对于选择正确的修复技术至关重要。在本研究中,我们评估了经常在关节镜诊断中使用的 Ellman 分类,研究了其在 MRI 扫描上的观察者内和观察者间可靠性。尽管平均观察者内评估结果为实质性一致(κ=0.795-0.721,分别),但观察者间评估结果仅为公平一致(κ=0.339-0.383-0.337,分别),第一位置评估除外(κ=0.414)。

结论 尽管观察者内可靠性令人满意,但由于观察者间可靠性仅为公平(除第一位置评估为中度一致外),因此仅使用 MRI 视图发现 Ellman 系统在部分厚度肩袖撕裂的分类中并不有用。

关键词

部分,肩袖,撕裂,Ellman 分类,可靠性,有效性。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验