Repo Jussi P, Pernaa Katri, Pekkanen Liisa, Hatakka Juho, Mäntymäki Heikki, Malmivaara Antti, Salo Henri, Suominen Eetu, Kankare Jyrki, Huttunen Jukka
Unit of Musculoskeletal Diseases, Department of Orthopedics and Traumatology, Tampere University Hospital and Tampere University, Tampere, Finland.
Department of Orthopaedics and Traumatology, Turku University Hospital, and University of Turku, Turku, Finland.
Brain Spine. 2025 Jul 9;5:104325. doi: 10.1016/j.bas.2025.104325. eCollection 2025.
The Finnish national spine surgery registry (FinSpine) collects data on patients, operative procedures, and outcomes.
Is the reliability of diagnosis collection for the FinSpine registry across various institutions sufficient?
A random sample of 110 spine surgeries performed in Finland since 2017 was selected from the FinSpine registry. Details of the operative procedures, including characteristics of the hospitals, primary and secondary diagnoses, the anatomical level of the spine surgery, and the date of the surgery, were recorded. Three experienced spine surgeons assessed radiographic imaging independently on two occasions with a one-month interval. Cohen and Fleiss kappa values were calculated for inter- and intra-rater reliability with registry diagnoses as the standard.
Altogether, 85 patients were included in the final analysis. The intra-rater reliability for primary diagnosis was moderate to almost perfect among all three evaluators, with Cohen's kappa values ranging from 0.765 to 0.847. In the inter-rater reliability analysis, there was moderate agreement between evaluators 1 and 2 (Cohen's κ = 0.592, SD 0.061) and evaluators 1 and 3 (κ = 0.595, SD 0.061). The agreement was substantial between evaluators 2 and 3 (κ = 0.676, SD 0.057). The Fleiss' kappa value was 0.622 (95 % CI from 0.570 to 0.673). The inter-rater reliability ranged from 0.596 to 0.652 when the evaluators' diagnoses were compared with those in the registry.
The primary diagnoses recorded in the FinSpine registry are reproducible and reliable, making the registry data valuable for further research and clinical decision-making.
芬兰国家脊柱手术登记处（FinSpine）收集有关患者、手术程序和结果的数据。
FinSpine登记处在不同机构间收集诊断信息的可靠性是否足够？
从FinSpine登记处选取2017年以来在芬兰进行的110例脊柱手术的随机样本。记录手术程序的详细信息，包括医院特征、主要和次要诊断、脊柱手术的解剖水平以及手术日期。三位经验丰富的脊柱外科医生在间隔一个月的两个时间点独立评估影像学检查结果。以登记处诊断为标准，计算科恩（Cohen）和弗莱斯（Fleiss）kappa值以评估评分者间和评分者内的可靠性。
最终分析共纳入85例患者。在所有三位评估者中，主要诊断的评分者内可靠性为中等至几乎完美，科恩kappa值范围为0.765至0.847。在评分者间可靠性分析中，评估者1和2之间有中等程度的一致性（科恩κ = 0.592，标准差0.061），评估者1和3之间有中等程度的一致性（κ = 0.595，标准差0.061）。评估者2和3之间的一致性较强（κ = 0.676，标准差0.057）。弗莱斯kappa值为0.622（95%置信区间为0.570至0.673）。将评估者的诊断与登记处的诊断进行比较时，评分者间可靠性范围为0.596至0.652。
FinSpine登记处记录的主要诊断具有可重复性和可靠性，使得登记处数据对进一步研究和临床决策具有价值。
