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. 2013;68(2):213-8.
doi: 10.6061/clinics/2013(02)oa15.

Interobserver agreement for the spine instability neoplastic score varies according to the experience of the evaluator

William Gemio Jacobsen Teixeira  1 , Pedro Ricardo de Mesquita Coutinho, Luiz Delboni Marchese, Douglas Kenji Narazaki, Alexandre Fogaça Cristante, Manoel Jacobsen Teixeira, Tarcísio Eloy Pessoa de Barros Filho, Olavo Pires de Camargo
Affiliations

Interobserver agreement for the spine instability neoplastic score varies according to the experience of the evaluator

William Gemio Jacobsen Teixeira et al. Clinics (Sao Paulo). 2013.

Abstract

Objectives: To evaluate the interobserver agreement for the Neoplastic Spine Instability Score (SINS) among spine surgeons with or without experience in vertebral metastasis treatment and physicians in other specialties.

Methods: Case descriptions were produced based on the medical records of 40 patients with vertebral metastases. The descriptions were then published online. Physicians were invited to evaluate the descriptions by answering questions according to the Neoplastic Spine Instability Score (SINS). The agreement among physicians was calculated using the kappa coefficient.

Results: Seventeen physicians agreed to participate: three highly experienced spine surgeons, seven less-experienced spine surgeons, three surgeons of other specialties, and four general practitioners (n = 17). The agreement for the final SINS score among all participants was fair, and it varied according to the SINS component. The agreement was substantial for the spine location only. The agreement was higher among experienced surgeons. The agreement was nearly perfect for spinal location among the spine surgeons who were highly experienced in vertebral metastases.

Conclusions: This study demonstrates that the experience of the evaluator has an impact on SINS scale classification. The interobserver agreement was only fair among physicians who were not spine surgeons and among spine surgeons who were not experienced in the treatment of vertebral metastases, which may limit the use of the SINS scale for the screening of unstable lesions by less-experienced evaluators.

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Conflict of interest statement

No potential conflict of interest was reported.

Figures

Figure 1
Figure 1
Example of a clinical case used in the evaluations. “Forty one-years-old patient with a diagnosis of metastatic colon adenocarcinoma. He has a complaint of progressive dorsal pain which is worse at night and with movement. The patient has a limited ability to move on the bed due to dorsal pain.” A. Anteroposterior and profile radiographs. B. Axial cut in computed tomography showing the lesion site.
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References

    1. Schiff D, O'Neill BP, Suman VJ. Spinal epidural metastasis as the initial manifestation of malignancy: clinical features and diagnostic approach. Neurology. 1997;49(2):452–6. - PubMed
    1. Patchell RA, Tibbs PA, Regine WF, Payne R, Saris S, Kryscio RJ, et al. Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial. Lancet. 2005;366(9486):643–8. - PubMed
    1. Sundaresan N, Digiacinto GV, Hughes JE, Cafferty M, Vallejo A. Treatment of neoplastic spinal cord compression: results of a prospective study. Neurosurgery. 1991;29(5):645–50. - PubMed
    1. Constans JP, de Divitiis E, Donzelli R, Spaziante R, Meder JF, Haye C. Spinal metastases with neurological manifestations. J Neurosurg. 1983;59(1):111–8. Review of 600 cases. - PubMed
    1. Eastley N, Newey M, Ashford RU. Skeletal metastases - The role of the orthopaedic and spinal surgeon. Surg Oncol. 2012. [Epub ahead of print] - PubMed

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