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Article: Comparison of reliability between the PUMC and lenke classification systems for classifying adolescent idiopathic scoliosis

TitleComparison of reliability between the PUMC and lenke classification systems for classifying adolescent idiopathic scoliosis
Authors
KeywordsAdolescent Idiopathic Scoliosis
Curve Classification
Lenke
Pumc
Issue Date2008
PublisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.com
Citation
Spine, 2008, v. 33 n. 22, p. E836-E842 How to Cite?
AbstractStudy Design. Comparison of 2 radiographic scoliosis classification systems by multiple surgeons. Objective. Compare the reliability of Peking Union Medical College (PUMC) and Lenke scoliosis classification systems and analyze their differences. Summary of Background Data. The PUMC classification is a newly reported system based on radiographic measurements with recent popularity, while the Lenke classification is widely accepted worldwide in surgical design. Both these classification systems have their own individual characteristics, hence it is necessary to compare their reliability. Methods. Five scoliosis surgeons independently evaluated and classified presurgical radiographs of 62 adolescent idiopathic scoliosis patients based on the PUMC and Lenke classification systems on 2 separate occasions. Radiographs were cleaned before each evaluation. Inter- and intraobserver reliabilities were quantified using Kappa statistics. Data were compared using χ analysis. Results. The PUMC classification's inter- and intraobserver percentage of agreement averaged to 91.0% (Kappa coefficient 0.896) and 90.2% (Kappa coefficient 0.892), respectively. While those of the Lenke curve type classification were 86.5% (Kappa coefficient 0.808) and 87.4% (Kappa coefficient 0.826). The PUMC classification from 10 individual measurements had 17 cases (27.4%) of disagreements, while in the Lenke curve type classification, 24 cases (38.7%) had disagreements. PUMC classification normally has discrepancies between type IIb, IIc, and IId, while Lenke classification has discrepancies in curve types 1 and 2. Out of 17 inconsistent PUMC curve type cases, 7 did not affect surgical fusion levels, while in the Lenke's only 2 out of 24 cases with discrepancies did not affect fusion range selection, with an obvious statistical difference. Conclusion. The reliability of both PUMC classification and Lenke curve type classification were categorized as good-to-excellent. PUMC classification is relatively simple, with less confusion among inter- and intraobservers, with corresponding surgical fusion guidance and planning. The mismatch of curve classification had less influence on PUMC's fusion range selection than Lenke's. © 2008 Lippincott Williams & Wilkins.
Persistent Identifierhttp://hdl.handle.net/10722/170135
ISSN
2015 Impact Factor: 2.439
2015 SCImago Journal Rankings: 1.459
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorQiu, Gen_US
dc.contributor.authorLi, Qen_US
dc.contributor.authorWang, Yen_US
dc.contributor.authorYu, Ben_US
dc.contributor.authorQian, Jen_US
dc.contributor.authorYu, Ken_US
dc.contributor.authorLee, CIen_US
dc.contributor.authorZhang, Jen_US
dc.contributor.authorShen, Jen_US
dc.contributor.authorZhao, Yen_US
dc.contributor.authorWeng, Xen_US
dc.contributor.authorWang, Ten_US
dc.contributor.authorAladin, DMKen_US
dc.contributor.authorLu, WWen_US
dc.date.accessioned2012-10-30T06:05:32Z-
dc.date.available2012-10-30T06:05:32Z-
dc.date.issued2008en_US
dc.identifier.citationSpine, 2008, v. 33 n. 22, p. E836-E842en_US
dc.identifier.issn0362-2436en_US
dc.identifier.urihttp://hdl.handle.net/10722/170135-
dc.description.abstractStudy Design. Comparison of 2 radiographic scoliosis classification systems by multiple surgeons. Objective. Compare the reliability of Peking Union Medical College (PUMC) and Lenke scoliosis classification systems and analyze their differences. Summary of Background Data. The PUMC classification is a newly reported system based on radiographic measurements with recent popularity, while the Lenke classification is widely accepted worldwide in surgical design. Both these classification systems have their own individual characteristics, hence it is necessary to compare their reliability. Methods. Five scoliosis surgeons independently evaluated and classified presurgical radiographs of 62 adolescent idiopathic scoliosis patients based on the PUMC and Lenke classification systems on 2 separate occasions. Radiographs were cleaned before each evaluation. Inter- and intraobserver reliabilities were quantified using Kappa statistics. Data were compared using χ analysis. Results. The PUMC classification's inter- and intraobserver percentage of agreement averaged to 91.0% (Kappa coefficient 0.896) and 90.2% (Kappa coefficient 0.892), respectively. While those of the Lenke curve type classification were 86.5% (Kappa coefficient 0.808) and 87.4% (Kappa coefficient 0.826). The PUMC classification from 10 individual measurements had 17 cases (27.4%) of disagreements, while in the Lenke curve type classification, 24 cases (38.7%) had disagreements. PUMC classification normally has discrepancies between type IIb, IIc, and IId, while Lenke classification has discrepancies in curve types 1 and 2. Out of 17 inconsistent PUMC curve type cases, 7 did not affect surgical fusion levels, while in the Lenke's only 2 out of 24 cases with discrepancies did not affect fusion range selection, with an obvious statistical difference. Conclusion. The reliability of both PUMC classification and Lenke curve type classification were categorized as good-to-excellent. PUMC classification is relatively simple, with less confusion among inter- and intraobservers, with corresponding surgical fusion guidance and planning. The mismatch of curve classification had less influence on PUMC's fusion range selection than Lenke's. © 2008 Lippincott Williams & Wilkins.en_US
dc.languageengen_US
dc.publisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.comen_US
dc.relation.ispartofSpineen_US
dc.subjectAdolescent Idiopathic Scoliosisen_US
dc.subjectCurve Classificationen_US
dc.subjectLenkeen_US
dc.subjectPumcen_US
dc.titleComparison of reliability between the PUMC and lenke classification systems for classifying adolescent idiopathic scoliosisen_US
dc.typeArticleen_US
dc.identifier.emailLu, WW:wwlu@hku.hken_US
dc.identifier.authorityLu, WW=rp00411en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1097/BRS.0b013e318187bb10en_US
dc.identifier.pmid18923307-
dc.identifier.scopuseid_2-s2.0-58149184326en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-58149184326&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume33en_US
dc.identifier.issue22en_US
dc.identifier.spageE836en_US
dc.identifier.epageE842en_US
dc.identifier.isiWOS:000260112700028-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridQiu, G=7103291762en_US
dc.identifier.scopusauthoridLi, Q=36068785500en_US
dc.identifier.scopusauthoridWang, Y=7601514529en_US
dc.identifier.scopusauthoridYu, B=7402093002en_US
dc.identifier.scopusauthoridQian, J=36875718300en_US
dc.identifier.scopusauthoridYu, K=23089555200en_US
dc.identifier.scopusauthoridLee, CI=8648129100en_US
dc.identifier.scopusauthoridZhang, J=8558508400en_US
dc.identifier.scopusauthoridShen, J=7404929807en_US
dc.identifier.scopusauthoridZhao, Y=23391635400en_US
dc.identifier.scopusauthoridWeng, X=7102593940en_US
dc.identifier.scopusauthoridWang, T=7405564819en_US
dc.identifier.scopusauthoridAladin, DMK=23491673700en_US
dc.identifier.scopusauthoridLu, WW=7404215221en_US

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