Improved interobserver variation after training of doctors in the Neer system. A randomised trial

TY - JOUR

T1 - Improved interobserver variation after training of doctors in the Neer system. A randomised trial

AU - Brorson, S

AU - Bagger, J

AU - Sylvest, A

AU - Hrøbjartsson, A

AU - Høbjartsson, A

PY - 2002

Y1 - 2002

N2 - We investigated whether training doctors to classify proximal fractures of the humerus according to the Neer system could improve interobserver agreement. Fourteen doctors were randomised to two training sessions, or to no training, and asked to categorise 42 unselected pairs of plain radiographs of fractures of the proximal humerus according to the Neer system. The mean kappa difference between the training and control groups was 0.30 (95% CI 0.10 to 0.50, p = 0.006). In the training group the mean kappa value for interobserver variation improved from 0.27 (95% CI 0.24 to 0.31) to 0.62 (95% CI 0.57 to 0.67). The improvement was particularly notable for specialists in whom kappa increased from 0.30 (95% CI 0.23 to 0.37) to 0.79 (95% CI 0.70 to 0.88). These results suggest that formal training in the Neer system is a prerequisite for its use in clinical practice and research.

AB - We investigated whether training doctors to classify proximal fractures of the humerus according to the Neer system could improve interobserver agreement. Fourteen doctors were randomised to two training sessions, or to no training, and asked to categorise 42 unselected pairs of plain radiographs of fractures of the proximal humerus according to the Neer system. The mean kappa difference between the training and control groups was 0.30 (95% CI 0.10 to 0.50, p = 0.006). In the training group the mean kappa value for interobserver variation improved from 0.27 (95% CI 0.24 to 0.31) to 0.62 (95% CI 0.57 to 0.67). The improvement was particularly notable for specialists in whom kappa increased from 0.30 (95% CI 0.23 to 0.37) to 0.79 (95% CI 0.70 to 0.88). These results suggest that formal training in the Neer system is a prerequisite for its use in clinical practice and research.

KW - Clinical Competence, Confidence Intervals, Humans, Humeral Fractures, Inservice Training, Observer Variation, Orthopedics

M3 - Journal article

SN - 0301-620X

VL - 84

SP - 950

EP - 954

JO - Journal of Bone and Joint Surgery: British Volume

JF - Journal of Bone and Joint Surgery: British Volume

IS - 7

ER -