Sherwood David, Haring R Sterling, Gill Benjamin, Miller Scott, Epps Adam, Zhivotenko Oksana, Khan Samir, Swenson Theodora L, Gardner James, Roehmer Christian, Martin Dann, Kennedy David J, Schneider Byron, Modic Michael, Udby Peter
University Health, Lakewood Medical Center, Department of Orthopedics, 7900 Lee's Summit Rd, Kansas City, MO, 64139, USA.
Vanderbilt University Medical Center, 2201 Children's Way, Suite 1318, Nashville, TN, 37212, USA.
Interv Pain Med. 2022 Apr 26;1(2):100092. doi: 10.1016/j.inpm.2022.100092. eCollection 2022 Jun.
Modic change grading is heterogeneous, inconsistent, and lacks a single nomenclature across the published literature. A new method of Modic change classification has been established by Dr. Peter Udby which hopes to unify how Modic changes are classified while also adding grading of the cranial/caudal extent of the Modic change across the vertebral body from the respective endplate involved to best capture the clinically relevant information of Modic changes.
Twenty magnetic resonance images of potential basivertebral nerve ablation candidates were independently reviewed by two board-certified and fellowship trained neuroradiologist and two board-certified and fellowship-trained interventional spine physiatrists for the presence and characterization of Modic changes using the newly described Udby classification. 100% agreement of all four reviewers of Modic change presence, Type, and Udby classification was required to be classified as agreement. There were 480 total data points each with 10 unique choices to compare across the four independent reviewers.
The kappa value of their agreement was 0.5899 (95% CI 0.4860-0.6939).
This study, requiring unanimous agreement between 4 physicians in application of the Udby classification, demonstrated an interrater reliability score of 0.5899 (95% CI 0.4860-0.6939). While this figure provides a first estimate, larger scale research is necessary before definitive claims regarding the interrater agreement validity of the Udby characterization system may be made.
Modic改变分级具有异质性、不一致性，且在已发表的文献中缺乏统一的命名法。彼得·乌迪博士建立了一种新的Modic改变分类方法，该方法希望统一Modic改变的分类方式，同时增加对Modic改变在椎体上从相应终板累及的头尾范围进行分级，以更好地获取Modic改变的临床相关信息。
两名获得委员会认证且经过专科培训的神经放射科医生和两名获得委员会认证且经过专科培训的介入脊柱物理治疗师，对20例潜在的椎体静脉神经消融候选者的磁共振图像进行独立审查，以使用新描述的乌迪分类法确定Modic改变的存在及特征。所有四名审查者对Modic改变的存在、类型和乌迪分类达成100%的一致意见才能被归类为达成共识。总共有480个数据点，每个数据点有10种独特的选择可供四名独立审查者进行比较。
他们的一致性kappa值为0.5899（95%可信区间0.4860 - 0.6939）。
本研究要求4名医生在应用乌迪分类法时达成一致意见，结果显示评分者间信度得分为0.5899（95%可信区间0.4860 - 0.6939）。虽然这个数字提供了一个初步估计，但在对乌迪特征系统的评分者间一致性有效性做出明确断言之前，还需要进行更大规模的研究。
