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Radiother Oncol. 2015 Apr;115(1):135-40. doi: 10.1016/j.radonc.2015.03.016. Epub 2015 Apr 10.

Agreement in the assessment of metastatic spine disease using scoring systems.

Author information

1
Department of Radiology, Valencian Oncology Institute Foundation, Valencia, Spain; Research Institute in Health Services Foundation, Valencia, Spain; Spanish Back Pain Research Network, Kovacs Foundation, Palma de Mallorca, Spain. Electronic address: aranae@uv.es.
2
Spanish Back Pain Research Network, Kovacs Foundation, Palma de Mallorca, Spain; Scientific Department, Kovacs Foundation, Palma de Mallorca, Spain.
3
Spanish Back Pain Research Network, Kovacs Foundation, Palma de Mallorca, Spain; CIBER Epidemiology and Public Health (CIBERESP), Spain; Clinical Biostatistics Unit, Hospital Ramón y Cajal, IRYCIS, Madrid, Spain.
4
Spanish Back Pain Research Network, Kovacs Foundation, Palma de Mallorca, Spain; Department of Radiology, Hospital Regional Universitario Carlos Haya, Málaga, Spain.
5
Spanish Back Pain Research Network, Kovacs Foundation, Palma de Mallorca, Spain; Center for Biomaterials and Tissue Engineering, Universitat Politècnica de València, Valencia, Spain.
6
Spanish Back Pain Research Network, Kovacs Foundation, Palma de Mallorca, Spain; CIBER Epidemiology and Public Health (CIBERESP), Spain; Clinical Biostatistics Unit, Hospital Ramón y Cajal, IRYCIS, Madrid, Spain; Barts and the London School of Medicine & Dentistry. Queen Mary University of London, London, UK.
7
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; CIBER Epidemiology and Public Health (CIBERESP), Spain; Clinical Biostatistics Unit. Hospital Ramón y Cajal, IRYCIS. Ctra. Colmenar Km. 9.1, 28034 Madrid, Spain.
8
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital Universitario la Princesa, Madrid, Spain.
9
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain.
10
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
11
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital Universitario Central de Asturias, Asturias, Spain.
12
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital Son Llàtzer, Palma de Mallorca, Spain.
13
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Complejo Hospitalario Universitario de Albacete, Albacete, Spain.
14
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital Universitario y Politécnico La Fe, Valencia, Spain.
15
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital Vall d'Hebron, Barcelona, Spain.
16
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital Nacional de Parapléjicos, Toledo, Spain.
17
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Fundación Instituto Valenciano de Oncología, Valencia, Spain.
18
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Instituto Oncológico Xanit, Benalmádena, Málaga, Spain.
19
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital Universitario Reina Sofía, Córdoba, Spain.
20
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; OSATEK. Hospital de Galdakao, Vizcaya, Spain.
21
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Consorcio hospitalario Provincial de Castellón, Castellón, Spain.
22
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital Universitario Cruces, Barakaldo, Vizcaya, Spain.
23
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital Universitario Puerta del Mar, Cádiz, Spain.
24
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital Clínico Universitario de Valencia, Valencia, Spain.
25
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital General Universitario Gregorio Marañón, Madrid, Spain.
26
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain.
27
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital Universitario la Paz, Madrid, Spain; HM Universitario Sanchinarro, Madrid, Spain.
28
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital Intermutual de Levante, San Antonio de Benagéber, Valencia, Spain.
29
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital Clinic de Barcelona, Barcelona, Spain.
30
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital de Manacor, Manacor, Islas Baleares, Spain.
31
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital Arnau de Vilanova, Valencia, Spain.
32
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
33
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; HM Universitario Sanchinarro, Madrid, Spain.
34
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital Universitario Marqués de Valdecilla, Santander, Spain.
35
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain.
36
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital Universitario Donostia, Donostia, Spain.
37
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Clínica Oncosur, Córdoba, Spain.
38
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Clínica Oncosur, Granada, Spain.
39
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
40
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital Doctor Peset, Valencia, Spain.
41
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital Duran i Reynals, l'Hospitalet de Llobregat, Barcelona, Spain.
42
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital POVISA, Vigo, Spain.
43
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital Universitario de Salamanca, Salamanca, Spain.
44
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital Universitario Virgen del Rocío, Sevilla, Spain.
45
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital Universitario de Canarias, Islas Canarias, Spain.
46
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital Universitario Virgen de las Nieves, Granada, Spain.
47
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital Universitario la Paz, Madrid, Spain.
48
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain.
49
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital 9 de Octubre, Valencia, Spain.
50
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.
51
Spanish Back Pain Research Network. Kovacs Foundation, Paseo de Mallorca 36, 07012 Palma de Mallorca, Spain; Complejo Hospitalario de Navarra, Navarra, Spain.

Abstract

PURPOSE:

To assess variability in the use of Tomita and modified Bauer scores in spine metastases.

MATERIALS AND METHODS:

Clinical data and imaging from 90 patients with biopsy-proven spinal metastases, were provided to 83 specialists from 44 hospitals. Spinal levels involved and the Tomita and modified Bauer scores for each case were determined twice by each clinician, with a minimum of 6-week interval. Clinicians were blinded to every evaluation. Kappa statistic was used to assess intra and inter-observer agreement. Subgroup analyses were performed according to clinicians' specialty (medical oncology, neurosurgery, radiology, orthopedic surgery and radiation oncology), years of experience (⩽7, 8-13, ⩾14), and type of hospital (four levels).

RESULTS:

For metastases identification, intra-observer agreement was "substantial" (0.60<k<0.80) at sacrum, and "almost perfect" (k>0.80) at the other levels. Inter-observer agreement was "almost perfect" at lumbar spine, and "substantial" at the other levels. Intra-observer agreement for the Tomita and Bauer scores was almost perfect. Inter-observer agreement was almost perfect for the Tomita score and substantial for the Bauer one. Results were similar across specialties, years of experience and type of hospital.

CONCLUSION:

Agreement in the assessment of metastatic spine disease is high. These scoring systems can improve communication among clinicians involved in oncology care.

KEYWORDS:

Agreement; Classification; Interobserver variability; Intraobserver variability; Magnetic resonance imaging; Spine metastases

PMID:
25869337
DOI:
10.1016/j.radonc.2015.03.016
[Indexed for MEDLINE]

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