Development and reliability of the AOSpine CROST (Clinician Reported Outcome Spine Trauma): a tool to evaluate and predi
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ORIGINAL ARTICLE
Development and reliability of the AOSpine CROST (Clinician Reported Outcome Spine Trauma): a tool to evaluate and predict outcomes from clinician’s perspective Said Sadiqi1 · Sander P. J. Muijs1 · Jeroen J. M. Renkens2 · Marcel W. Post3,4 · Lorin M. Benneker5 · Jens R. Chapman6 · Frank Kandziora7 · Klaus J. Schnake8 · Emiliano N. Vialle9 · Alexander R. Vaccaro10 · F. Cumhur Oner1 Received: 1 November 2019 / Revised: 28 May 2020 / Accepted: 20 June 2020 © The Author(s) 2020
Abstract Purpose To report on the development of AOSpine CROST (Clinician Reported Outcome Spine Trauma) and results of an initial reliability study. Methods The AOSpine CROST was developed using an iterative approach of multiple cycles of development, review, and revision including an expert clinician panel. Subsequently, a reliability study was performed among an expert panel who were provided with 20 spine trauma cases, administered twice with 4-week interval. The results of the developmental process were analyzed using descriptive statistics, the reliability per parameter using Kappa statistics, inter-rater rater agreement using intraclass correlation coefficient (ICC), and internal consistency using Cronbach’s α. Results The AOSpine CROST was developed and consisted of 10 parameters, 2 of which are only applicable for surgically treated patents (‘Wound healing’ and ‘Implants’). A dichotomous scoring system (‘yes’ or ‘no’ response) was incorporated to express expected problems for the short term and long term. In the reliability study, 16 (84.2%) participated in the first round and 14 (73.7%) in the second. Intra-rater reliability was fair to good for both time points (κ = 0.40–0.80 and κ = 0.31–0.67). Results of inter-rater reliability were lower (κ = 0.18–0.60 and κ = 0.16–0.46). Inter-rater agreement for total scores showed moderate results (ICC = 0.52–0.60), and the internal consistency was acceptable (α = 0.76–0.82). Conclusions The AOSpine CROST, an outcome tool for the surgeons, was developed using an iterative process. An initial reliability analysis showed fair to moderate results and acceptable internal consistency. Further clinical validation studies will be performed to further validate the tool. Keywords Outcome instrument · AOSpine CROST · Spine trauma · Clinical parameters · Radiological parameters · Clinician perspective
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Department of Traumatology and Orthopaedic Surgery, Inselspital University of Bern, Bern, Switzerland
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Swedish Neuroscience Institute, Swedish Medical Center, Seattle, WA, USA
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Department of Orthopaedics, Erasmus Medical Center, Rotterdam, The Netherlands
Center for Spinal Surgery, BGU-Hospital, Frankfurt, Germany
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Rehabilitation Center ‘De Hoogstraat’, Utrecht, The Netherlands
Center for Spinal Surgery, Schön Klinik Nürnberg Fürth, Fürth, Germany
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Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, Groningen, The Netherlands
Cajuru Hospital, Catholic University of Parana, Caritiba, Brazil
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Depart
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