Training improves agreement among doctors using the Neer system for proximal humeral fractures in a systematic review
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Standard
Training improves agreement among doctors using the Neer system for proximal humeral fractures in a systematic review. / Brorson, Stig; Hróbjartsson, Asbjørn.
I: Journal of Clinical Epidemiology, Bind 61, Nr. 1, 2008, s. 7-16.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Training improves agreement among doctors using the Neer system for proximal humeral fractures in a systematic review
AU - Brorson, Stig
AU - Hróbjartsson, Asbjørn
PY - 2008
Y1 - 2008
N2 - ObjectiveTo systematically review studies of observer agreement among doctors classifying proximal humeral fractures according to the Neer system.Study Design and SettingA systematic review. We searched for observational studies in which doctors classified proximal humeral fractures according to the Neer system, and randomized trials of any intervention aimed at improving agreement. We analyzed potential eligible studies independently, and data were extracted using pretested forms. Authors were contacted for missing information. Summary statistics for observer agreement were noted, and the methodological quality was assessed.ResultsWe included 11 observational studies (88 observers and 468 cases). Mean κ-values for interobserver agreement ranged from 0.17 to 0.52. Agreement did not improve through selection of experienced observers, advanced imaging modalities, or simplification of the classification system. Intra-observer agreement was moderately higher than interobserver agreement. One randomized trial (14 observers and 42 cases) reported a clear effect of training (mean κ-value 0.62 after training compared to no training 0.34).ConclusionWe found a consistently low level of observer agreement. The widely held belief that experts disagree less than nonexperts could not be supported. One randomized trial indicated that training improves agreement among both experts and nonexperts.
AB - ObjectiveTo systematically review studies of observer agreement among doctors classifying proximal humeral fractures according to the Neer system.Study Design and SettingA systematic review. We searched for observational studies in which doctors classified proximal humeral fractures according to the Neer system, and randomized trials of any intervention aimed at improving agreement. We analyzed potential eligible studies independently, and data were extracted using pretested forms. Authors were contacted for missing information. Summary statistics for observer agreement were noted, and the methodological quality was assessed.ResultsWe included 11 observational studies (88 observers and 468 cases). Mean κ-values for interobserver agreement ranged from 0.17 to 0.52. Agreement did not improve through selection of experienced observers, advanced imaging modalities, or simplification of the classification system. Intra-observer agreement was moderately higher than interobserver agreement. One randomized trial (14 observers and 42 cases) reported a clear effect of training (mean κ-value 0.62 after training compared to no training 0.34).ConclusionWe found a consistently low level of observer agreement. The widely held belief that experts disagree less than nonexperts could not be supported. One randomized trial indicated that training improves agreement among both experts and nonexperts.
KW - Clinical Competence, Education, Medical, Continuing, Humans, Information Storage and Retrieval, Observer Variation, Radiology, Randomized Controlled Trials as Topic, Shoulder Fractures
U2 - 10.1016/j.jclinepi.2007.04.014
DO - 10.1016/j.jclinepi.2007.04.014
M3 - Journal article
C2 - 18083458
VL - 61
SP - 7
EP - 16
JO - Journal of Clinical Epidemiology
JF - Journal of Clinical Epidemiology
SN - 0895-4356
IS - 1
ER -
ID: 10209430