Cummings R J, Loveless E A, Campbell J, Samelson S, Mazur J M
Nemours Children's Clinic, Jacksonville, Florida 32207, USA.
J Bone Joint Surg Am. 1998 Aug;80(8):1107-11. doi: 10.2106/00004623-199808000-00003.
The classification of adolescent idiopathic scoliosis with use of the system of King et al. has become widely accepted since its introduction. The purpose of the present study was to establish the interobserver reliability and intraobserver reproducibility of this classification system. The preoperative radiographs of sixty-three patients who were managed operatively for adolescent idiopathic scoliosis were classified by five observers with the system of King et al. Interobserver reliability was assessed by comparison of the classification of the curves among the observers, and intraobserver reproducibility was evaluated by comparison of the classifications of each set of radiographs by each observer on two occasions three weeks apart. The median interobserver reliability kappa coefficient for the classification system of King et al. was 0.44 (range, 0.28 to 0.50), and the median intraobserver reproducibility kappa coefficient was 0.64 (range, 0.44 to 0.72). According to the definition of Landis and Koch, the classification system of King et al. is substantially reproducible but is only moderately reliable. However, according to the stricter definition of Svanholm et al., its reproducibility is only fair and its reliability is poor.
自引入以来，使用金氏（King）等人的系统对青少年特发性脊柱侧凸进行分类已被广泛接受。本研究的目的是确定该分类系统的观察者间可靠性和观察者内可重复性。由五名观察者使用金氏等人的系统对63例接受手术治疗的青少年特发性脊柱侧凸患者的术前X线片进行分类。通过比较观察者之间曲线的分类来评估观察者间可靠性，通过比较每位观察者在相隔三周的两个时间点对每组X线片的分类来评估观察者内可重复性。金氏等人分类系统的观察者间可靠性kappa系数中位数为0.44（范围为0.28至0.50），观察者内可重复性kappa系数中位数为0.64（范围为0.44至0.72）。根据兰迪斯（Landis）和科克（Koch）的定义，金氏等人的分类系统具有相当的可重复性，但仅具有中等可靠性。然而，根据斯万霍尔姆（Svanholm）等人更严格的定义，其可重复性仅为一般，可靠性较差。
