Agreement in metastatic spinal cord compression

Estanislao Arana; Francisco M. Kovacs; Ana Royuela; Beatriz Asenjo; Úrsula Pérez-Ramírez; Javier Zamora

doi:10.6004/jnccn.2016.0008

Agreement in metastatic spinal cord compression

Estanislao Arana^*, Francisco M. Kovacs, Ana Royuela, Beatriz Asenjo, Úrsula Pérez-Ramírez, Javier Zamora

^*Corresponding author for this work

Metabolism and Systems Research

Research output: Contribution to journal › Article › peer-review

6 Citations (Scopus)

Abstract

Background: Metastatic epidural spinal cord compression (ESCC) is a devastating medical emergency. The purpose of this study was to determine the reliability of the 6-point ESCC scoring system and the identification of the spinal level presenting ESCC. Methods: Clinical data and imaging from 90 patients with biopsy-proven spinal metastases were provided to 83 specialists from 44 hospitals. The spinal levels presenting metastases and the ESCC scores for each case were calculated twice by each clinician, with a minimum of 6 weeks' interval. Clinicians were blinded to assessments made by other specialists and their own previous assessment. Fleiss kappa (κ) statistic was used to assess intraobserver and interobserver agreement. Subgroup analyses were performed according to clinicians' specialty (medical oncology, neurosurgery, radiology, orthopedic surgery, and radiation oncology), years of experience, and type of hospital. Results: Intraobserver and interobserver agreement on the location of ESCC was substantial (κ>0.61). Intraobserver agreement on the ESCC score was "excellent" (κ=0.82), whereas interobserver agreement was substantial (κ=0.64). Overall agreement with the tumor board classification was substantial (κ=0.71). Results were similar across specialties, years of experience and hospital category. Conclusions: The ESCC score can help improve communication among clinicians involved in oncology care.

Original language	English
Pages (from-to)	70-76
Number of pages	7
Journal	JNCCN Journal of the National Comprehensive Cancer Network
Volume	14
Issue number	1
DOIs	https://doi.org/10.6004/jnccn.2016.0008
Publication status	Published - 1 Jan 2016

Bibliographical note

Funding Information:
*The view members of the Spanish Back Pain Research Network Task Force, see supplemental eAppendix 1 (available with this issue, at JNCCN.org). Submitted June 22, 2015; accepted for publication September 4, 2015. The authors have disclosed that they have no financial interests, arrangements, affiliations, or commercial interests with the manufacturers of any products discussed in this article or their competitors. Funding for this work was provided by The Kovacs Foundation. Correspondence: Estanislao Arana, MD, MHE, PhD, Fundación Instituto Valenciano de Oncología, C/ Beltrán Báguena, 19, 46009 Valencia, Spain. E-mail: aranae@uv.es

Publisher Copyright:
© 2016 Harborside Press. All rights reserved.

ASJC Scopus subject areas

Oncology

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10.6004/jnccn.2016.0008

Cite this

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title = "Agreement in metastatic spinal cord compression",

abstract = "Background: Metastatic epidural spinal cord compression (ESCC) is a devastating medical emergency. The purpose of this study was to determine the reliability of the 6-point ESCC scoring system and the identification of the spinal level presenting ESCC. Methods: Clinical data and imaging from 90 patients with biopsy-proven spinal metastases were provided to 83 specialists from 44 hospitals. The spinal levels presenting metastases and the ESCC scores for each case were calculated twice by each clinician, with a minimum of 6 weeks' interval. Clinicians were blinded to assessments made by other specialists and their own previous assessment. Fleiss kappa (κ) statistic was used to assess intraobserver and interobserver agreement. Subgroup analyses were performed according to clinicians' specialty (medical oncology, neurosurgery, radiology, orthopedic surgery, and radiation oncology), years of experience, and type of hospital. Results: Intraobserver and interobserver agreement on the location of ESCC was substantial (κ>0.61). Intraobserver agreement on the ESCC score was {"}excellent{"} (κ=0.82), whereas interobserver agreement was substantial (κ=0.64). Overall agreement with the tumor board classification was substantial (κ=0.71). Results were similar across specialties, years of experience and hospital category. Conclusions: The ESCC score can help improve communication among clinicians involved in oncology care.",

author = "Estanislao Arana and Kovacs, {Francisco M.} and Ana Royuela and Beatriz Asenjo and {\'U}rsula P{\'e}rez-Ram{\'i}rez and Javier Zamora",

note = "Funding Information: *The view members of the Spanish Back Pain Research Network Task Force, see supplemental eAppendix 1 (available with this issue, at JNCCN.org). Submitted June 22, 2015; accepted for publication September 4, 2015. The authors have disclosed that they have no financial interests, arrangements, affiliations, or commercial interests with the manufacturers of any products discussed in this article or their competitors. Funding for this work was provided by The Kovacs Foundation. Correspondence: Estanislao Arana, MD, MHE, PhD, Fundaci{\'o}n Instituto Valenciano de Oncolog{\'i}a, C/ Beltr{\'a}n B{\'a}guena, 19, 46009 Valencia, Spain. E-mail: aranae@uv.es Publisher Copyright: {\textcopyright} 2016 Harborside Press. All rights reserved.",

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T1 - Agreement in metastatic spinal cord compression

AU - Arana, Estanislao

AU - Kovacs, Francisco M.

AU - Royuela, Ana

AU - Asenjo, Beatriz

AU - Pérez-Ramírez, Úrsula

AU - Zamora, Javier

N1 - Funding Information: *The view members of the Spanish Back Pain Research Network Task Force, see supplemental eAppendix 1 (available with this issue, at JNCCN.org). Submitted June 22, 2015; accepted for publication September 4, 2015. The authors have disclosed that they have no financial interests, arrangements, affiliations, or commercial interests with the manufacturers of any products discussed in this article or their competitors. Funding for this work was provided by The Kovacs Foundation. Correspondence: Estanislao Arana, MD, MHE, PhD, Fundación Instituto Valenciano de Oncología, C/ Beltrán Báguena, 19, 46009 Valencia, Spain. E-mail: aranae@uv.es Publisher Copyright: © 2016 Harborside Press. All rights reserved.

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Background: Metastatic epidural spinal cord compression (ESCC) is a devastating medical emergency. The purpose of this study was to determine the reliability of the 6-point ESCC scoring system and the identification of the spinal level presenting ESCC. Methods: Clinical data and imaging from 90 patients with biopsy-proven spinal metastases were provided to 83 specialists from 44 hospitals. The spinal levels presenting metastases and the ESCC scores for each case were calculated twice by each clinician, with a minimum of 6 weeks' interval. Clinicians were blinded to assessments made by other specialists and their own previous assessment. Fleiss kappa (κ) statistic was used to assess intraobserver and interobserver agreement. Subgroup analyses were performed according to clinicians' specialty (medical oncology, neurosurgery, radiology, orthopedic surgery, and radiation oncology), years of experience, and type of hospital. Results: Intraobserver and interobserver agreement on the location of ESCC was substantial (κ>0.61). Intraobserver agreement on the ESCC score was "excellent" (κ=0.82), whereas interobserver agreement was substantial (κ=0.64). Overall agreement with the tumor board classification was substantial (κ=0.71). Results were similar across specialties, years of experience and hospital category. Conclusions: The ESCC score can help improve communication among clinicians involved in oncology care.

AB - Background: Metastatic epidural spinal cord compression (ESCC) is a devastating medical emergency. The purpose of this study was to determine the reliability of the 6-point ESCC scoring system and the identification of the spinal level presenting ESCC. Methods: Clinical data and imaging from 90 patients with biopsy-proven spinal metastases were provided to 83 specialists from 44 hospitals. The spinal levels presenting metastases and the ESCC scores for each case were calculated twice by each clinician, with a minimum of 6 weeks' interval. Clinicians were blinded to assessments made by other specialists and their own previous assessment. Fleiss kappa (κ) statistic was used to assess intraobserver and interobserver agreement. Subgroup analyses were performed according to clinicians' specialty (medical oncology, neurosurgery, radiology, orthopedic surgery, and radiation oncology), years of experience, and type of hospital. Results: Intraobserver and interobserver agreement on the location of ESCC was substantial (κ>0.61). Intraobserver agreement on the ESCC score was "excellent" (κ=0.82), whereas interobserver agreement was substantial (κ=0.64). Overall agreement with the tumor board classification was substantial (κ=0.71). Results were similar across specialties, years of experience and hospital category. Conclusions: The ESCC score can help improve communication among clinicians involved in oncology care.

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DO - 10.6004/jnccn.2016.0008

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JF - JNCCN Journal of the National Comprehensive Cancer Network

IS - 1

ER -

Agreement in metastatic spinal cord compression

Abstract

Bibliographical note

ASJC Scopus subject areas

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