尾巴马体综合征是什么意思
Ingrid Hoeritzauer1,2, Mhairi Paterson1, Aimun A B Jamjoom1,2
1Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
The bone & joint journal
|August 31, 2023
概括
临床医生对尾尾马综合征 (CES) 分类的共识很低,即使对于经验丰富的外科医生来说也是如此. 由于潜在的异质性,在临床实践和研究中应谨慎使用这些分类.
科学领域:
- 神经外科 神经外科
- 临床神经学 临床神经学
- 脊髓损伤研究研究脊髓损伤研究
背景情况:
- 马尾综合征 (CES) 需要紧急的手术减压和成像.
- 预后和CES的管理可能会受到症状严重程度和类型的影响.
- 现有的CES类别旨在为管理和预后标准化患者分组.
研究的目的:
- 评估现有的尾马综合征 (CES) 分类系统的评价者间可靠性.
- 确定当前的CES类别是否可以在临床实践和研究环境中可靠地应用.
主要方法:
- 一项文献审查确定了已发表的CES类别定义.
- 100个CES患者的匿名临床图片被咨询脊椎外科医生,神经外科注册人员和医学学生评估.
- 通过使用Fleiss的kappa统计数据,对各种评级者群体和CES类别进行了量化.
主要成果:
- 没有一个评级团队在任何CES类别中实现了实质性的评级者间协议.
- 在"CES与尿"和所有其他类别 (kappa=0.34) 之间观察到最高的一致性.
- 与临床经验相比,评价者之间的一致性没有得到改善;咨询脊椎外科医生显示了最低的一致性 (kappa=0.17).
结论:
- 目前对尾巴马综合征 (CES) 的分类表明临床医生之间的评价者间可靠性较低.
- 根据目前的类别定义,CES患者群体内的异质性表明,在临床决策和研究中使用它们时要谨慎.
- 可能需要进一步完善CES分类系统,以提高患者管理和研究结果的一致性和可比性.
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