Evidence map›Paper›PMID 38609938›Full record

ArticleBMC musculoskeletal disorders2024

Reliability of thoracolumbar burst fracture classification in the Swedish Fracture Register.

Simon Blixt, Fabian Burmeister, Sebastian Mukka, Lukas Bobinski, Peter Försth, Olof Westin, Paul Gerdhem

Abstract read
In one paragraph

Article in BMC musculoskeletal disorders, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. The epidemiology of odontoid fractures: a study from the Swedish fracture register.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Simon BlixtDepartment of Orthopaedics and Hand surgery, Uppsala University Hospital, Uppsala, Sweden. simon.blixt@akademiska.se.ORCID http://orcid.org/0000-0001-9549-2375
Fabian BurmeisterDepartment of Surgical and Perioperative Sciences (Orthopaedics), Umeå University, Umeå, Sweden.ORCID http://orcid.org/0009-0001-0624-8707
Sebastian MukkaDepartment of Surgical and Perioperative Sciences (Orthopaedics), Umeå University, Umeå, Sweden.ORCID http://orcid.org/0000-0002-5469-2730
Lukas BobinskiDepartment of Surgical and Perioperative Sciences (Orthopaedics), Umeå University, Umeå, Sweden.ORCID http://orcid.org/0000-0002-3651-2687
Peter FörsthDepartment of Surgical Sciences, Uppsala University, Uppsala, Sweden.ORCID http://orcid.org/0000-0002-6699-8868
Olof WestinDepartment of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.ORCID http://orcid.org/0000-0002-8416-8905
Paul GerdhemDepartment of Orthopaedics and Hand surgery, Uppsala University Hospital, Uppsala, Sweden.ORCID http://orcid.org/0000-0001-8061-7163

Funding

Vetenskapsrådet 2020-00493
6 · The paper itself

Abstract

backgroundThe Swedish Fracture Register (SFR) is a national quality register for all types of fractures in Sweden. Spine fractures have been included since 2015 and are classified using a modified AOSpine classification. The aim of this study was to determine the accuracy of the classification of thoracolumbar burst fractures in the SFR.

methodsAssessments of medical images were conducted in 277 consecutive patients with a thoracolumbar burst fracture (T10-L3) identified in the SFR. Two independent reviewers classified the fractures according to the AOSpine classification, with a third reviewer resolving disagreement. The combined results of the reviewers were considered the gold standard. The intra- and inter-rater reliability of the reviewers was determined with Cohen's kappa and percent agreement. The SFR classification was compared with the gold standard using positive predictive values (PPV), Cohen's kappa and percent agreement.

resultsThe reliability between reviewers was  high (Cohen's kappa 0.70-0.97). The PPV for correctly classifying burst fractures in the SFR was high irrespective of physician experience (76-89%), treatment (82% non-operative, 95% operative) and hospital type (83% county, 95% university). The inter-rater reliability of B-type injuries and the overall SFR classification compared with the gold standard was low (Cohen's kappa 0.16 and 0.17 respectively).

conclusionsThe SFR demonstrates a high PPV for accurately classifying burst fractures, regardless of physician experience, treatment and hospital type. However, the reliability of B-type injuries and overall classification in the SFR was found to be low. Future studies on burst fractures using SFR data where classification is important should include a review of medical images to verify the diagnosis.

Indexed as

Fractures, BoneFractures, ComminutedSpinal FracturesHumansReproducibility of ResultsRetrospective StudiesSwedenAccuracyAgreementBurst fractureClassificationRegister-basedReliabilityThoracolumbar

Identifiers

PMID38609938
PMCPMC11010401

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.