scholarly journals Is the AO spine thoracolumbar injury classification system reliable and practical? a systematic review

2021 ◽  
Vol 87 (1) ◽  
pp. 181-190
Author(s):  
Zion Hwang ◽  
James Houston ◽  
Evangelos M. Fragakis ◽  
Cristina Lupu ◽  
Jason Bernard ◽  
...  
Keyword(s):  
Systematic Review ◽  
Classification System ◽  
Data Extraction ◽  
Cochrane Collaboration ◽  
Classification Systems ◽  
Science Data ◽  
Thoracolumbar Injury ◽  
Type Classification ◽  
Injury Classification

Controversy surrounding the classification of thoracolumbar injuries has given rise to various classification systems over the years, including the most recent AOSpine Thoracolumbar Injury Classification System (ATLICS). This systematic review aims to provide an up-to-date evaluation of the literature, including assessment of a further three studies not analysed in previous reviews. In doing so, this is the first systematic review to include the reliability among non-spine subspecialty professionals and to document the wide variety between reliability across studies, particularly with regard to sub-type classification. Relevant studies were found via a systematic search of PubMed, EBESCO, Cochrane and Web of Science. Data extraction and quality assessment were conducted in line with Cochrane Collaboration guidelines. Twelve articles assessing the reliability of ATLICS were included in this review. The overall inter-observer reliability varied from fair to substantial, but the three additional studies in this review, compared to previous reviews, presented on average only fair reliability. The greatest variation of results was seen in A1 and B3 subtypes. Least reliably classified on average was A4 subtype. This systematic review concludes that ATLICS is reliable for the majority of injuries, but the variability within subtypes suggests the need for further research in assessing the needs of users in order to increase familiarity with ATLICS or perhaps the necessity to include more subtype-specific criteria into the system. Further research is also recommended on the reliability of modifiers, neurological classification and the application of ATLICS in a paediatric context.

scholarly journals The classifications of subaxial cervical spine traumatic injuries. Part 4. AOSpine Subaxial Classification System

2021 ◽  
Vol 27 (1) ◽  
pp. 3-10
Author(s):  
Oleksii S. Nekhlopochyn ◽  
Ievgenii I. Slynko ◽  
Vadim V. Verbov
Keyword(s):  
Cervical Spine ◽  
Treatment Strategy ◽  
Classification System ◽  
Neurological Status ◽  
Classification Systems ◽  
Cervical Spine Injuries ◽  
Subaxial Cervical Spine ◽  
Spine Injuries ◽  
Injury Classification

Cervical spine injuries are a fairly common consequence of mechanical impact on the human body. The subaxial level of the cervical spine accounts for approximately half to 2/3 of these injuries. Despite the numerous classification systems that exist for describing these injuries, the recommendations for treatment strategy are very limited, and currently none of them is universal and generally accepted. Consequently, treatment decisions are based on the individual experience of the specialist, but not on evidence or algorithms. While the classification system based on the mechanism of trauma originally proposed by B.L. Allen et al. and subsequently modified by J.H. Harris Jr et al., was comprehensive, but lacked evidence, which to some extent limited its clinical applicability. Similarly, the Subaxial Injury Classification System proposed by the Spine Trauma Group, had no distinct and clinically significant patterns of morphological damage. This fact hindered the standardization and unification of tactical approaches. As an attempt to solve this problem, in 2016 Alexander Vaccaro, together with AO Spine, proposed the AO Spine subaxial cervical spine injury classification system, using the principle of already existing AOSpine classification of thoracolumbar injuries. The aim of the project was to develop an effective system that provides clear, clinically relevant morphological descriptions of trauma patterns, which should contribute to the determination of treatment strategy. The proposed classification of cervical spine injuries at the subaxial level follows the same hierarchical approach as previous AO classifications, namely, it characterizes injuries based on 4 parameters: (1) injury morphology, (2) facet damage, (3) neurological status, and (4) specific modifiers. The morphology of injuries is divided into 3 subgroups of injuries: A (compression), B (flexion-distraction), and C (dislocations and displacements). Damage types A and B are divided into 5 (A0-A4) and 3 (B1-B3) subtypes, respectively. When describing damage of the facet joints, 4 subtypes are distinguished: F1 (fracture without displacement), F2 (unstable fracture), F3 (floating lateral mass) and F4 (dislocation). The system also integrates the assessment of neurological status, which is divided into 6 subtype). In addition, the classification includes 4 specific modifiers designed to better detail a number of pathological conditions. The performance evaluation of AOSpine SCICS showed a moderate to significant range of consistency and reproducibility. Currently, a quantitative scale for assessing the severity of classification classes has been proposed, which also, to a certain extent, contributes to decision-making regarding treatment strategy.

scholarly journals CURRENTLY AVAILABLE CLASSIFICATION SYSTEMS FOR LOWER CERVICAL SPINE INJURIES. PART 2. SYSTEMATIC REVIEW OF STUDIES ON THE RELIABILITY AND REPRODUCIBILITY OF EXISTING SCALES

2019 ◽  
Vol 21 (2) ◽  
pp. 28-38
Author(s):  
А. А. Grin ◽  
I. S. Lvov ◽  
S. L. Arakelyan ◽  
А. E. Talypov ◽  
А. Yu. Kordonsky ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cervical Spine ◽  
Classification System ◽  
Small Sample ◽  
Classification Systems ◽  
Lower Cervical Spine ◽  
Study Objective ◽  
Cervical Spine Injuries ◽  
Spine Injuries ◽  
Injury Classification

The study objective is to review the Russian and foreign studies and to identify an optimal classification system for lower cervical spine injuries. Materials and methods. This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We conducted a search for articles published in English (PubMed database) and Russian (eLIBRARY.ru). The inclusion criteria were as follows: available full text, patient age ≥18 years, and information on one of the validation phases for classifications according to L. Audige et al. Results. A total of 30 articles were eligible. Of them, 3 studies were published in Russian (by one group of authors); however, they didn’t contain required statistical parameters and had duplicated data; therefore, they were excluded from the analysis. Out of 27 articles published in English, 8 articles met all the criteria and were included into the systematic review. The AOSpine and Subaxial Injury Classification Systems demonstrated the highest reliability and reproducibility of the results. The Allen–Fergusson classification has lower intraobserver and interobserver agreement coefficients, but it can give a clearer visual representation of injuries. We also assessed J. Harris classification system. The reliability of the scale developed by С. Argenson et al. was not evaluated. The analyzed publications contained no data for full evaluation of the Cervical Spine Injury Severity Score. Our analysis clearly demonstrated the need for a more thorough evaluation of all available scales and classifications. This study should be multicenter and involve experts with different levels of experience (from residents to experienced spinal surgeons). Moreover, it should analyze not only the reproducibility of individual classifications, but also the aspects of learning and the relationship between individual scales and systems. The main study limitations included insufficient number of publications, small sample sizes, heterogeneity of groups, and differences in the experience of experts. Conclusion. The AOSpine and Subaxial Injury Classification Systems are the most reliable classification systems. However, the data available in literature is not sufficient for a full comparison of all existing scales and systems. Further multicenter studies on the reliability of classifications are needed to select an optimal one.

scholarly journals Reliability and Validity of the AOSpine Thoracolumbar Injury Classification System: A Systematic Review

2018 ◽  
Vol 9 (2) ◽  
pp. 231-242 ◽  
Author(s):  
Aidin Abedi ◽  
Lidwine B. Mokkink ◽  
Shayan Abdollah Zadegan ◽  
Permsak Paholpak ◽  
Koji Tamai ◽  
...  
Keyword(s):  
Systematic Review ◽  
Classification System ◽  
Methodological Quality ◽  
Reliability And Validity ◽  
Measurement Properties ◽  
Moderate Evidence ◽  
Thoracolumbar Injury ◽  
Injury Classification ◽  
Morphologic Classification

Study Design: Systematic review. Objectives: The AOSpine thoracolumbar injury classification system (ATLICS) is a relatively simple yet comprehensive classification of spine injuries introduced in 2013. This systematic review summarizes the evidence on measurement properties of this new classification, particularly the reliability and validity of the main morphologic injury types with and without inclusion of the subtypes. Methods: A literature search was performed using PubMed and Embase in September 2016. A revised version of the COSMIN checklist was used for evaluation of the quality of studies. Two independent reviewers performed all steps of the review. Results: Nine articles were included in the final review, all of which evaluated the reliability of the ATLICS and had a fair methodological quality. The reliability of the modifiers was unknown. Overall, the quality of evidence for reliability of the morphologic and neurologic classification sections was low. However, there was moderate evidence for poor interobserver reliability of the morphologic classification when all subtypes were included, and moderate evidence for good intraobserver reliability with exclusion of subtypes. The reliability of the morphologic classification was independent of the observer’s experience and cultural background. Conclusions: ATLICS represents the most current system for evaluation of thoracolumbar injuries. Based on this review, further studies with robust methodological quality are needed to evaluate the measurement properties of ATLICS. Shortcomings of the reliability studies are discussed.

scholarly journals The Classification of Long Bone Osteomyelitis: A Systemic Review of the Literature

2017 ◽  
Vol 2 (4) ◽  
pp. 167-174 ◽  
Author(s):  
Andrew J. Hotchen ◽  
Martin A. McNally ◽  
Parham Sendi
Keyword(s):  
Systematic Review ◽  
Soft Tissue ◽  
Classification System ◽  
Classification Systems ◽  
Bone Involvement ◽  
Long Bone ◽  
Soft Tissue Coverage ◽  
Host Status ◽  
Long Bone Osteomyelitis

Abstract. Background: Osteomyelitis is a complex disease. Treatment involves a combination of bone resection, antimicrobials and soft-tissue coverage. There is a difficulty in unifying a classification system for long bone osteomyelitis that is generally accepted.Objectives: In this systematic review, we aim to investigate the classification systems for long bone osteomyelitis that have been presented within the literature. By doing this, we hope to elucidate the important variables that are required when classifying osteomyelitis.Methods: A complete search of the Medline, EMBASE, Cochrane and Ovid databases was undertaken. Following exclusion criteria, 13 classification systems for long-bone osteomyelitis were included for review.Results: The 13 classification systems that were included for review presented seven different variables that were used for classification. Ten of them used only one main variable, two used two variables and one used seven variables. The variables included bone involvement (used in 7 classification systems), acute versus chronic infection (used in 6), aetiopathogenesis (used in 3), host status (used in 3), soft tissue (used in 2), microbiology (used in 1) and location of infected bone (used in 1). The purpose of each classification system could be grouped as either descriptive (3 classification systems), prognostic (4) or for management (4). Two of the 13 classification systems were for both prognostic and management purposes.Conclusions: This systematic review has demonstrated a variety of variables used for classification of long bone osteomyelitis. While some variables are used to guide management and rehabilitation after surgery (e.g., bone defect, soft tissue coverage), others were postulated to provide prognostic information (e.g., host status). Finally, some variables were used for descriptive purposes only (aetiopathogenesis). In our view and from today's perspective, bone involvement, antimicrobial resistance patterns of causative micro-organisms, the need for soft-tissue coverage and host status are important variables to include in a classification system.

scholarly journals Toward the Development of a Comprehensive Clinically Oriented Patient Profile: A Systematic Review of the Purpose, Characteristic, and Methodological Quality of Classification Systems of Adult Spinal Deformity

Neurosurgery ◽  
2021 ◽  
Author(s):  
Kenny Yat Hong Kwan ◽  
J Naresh-Babu ◽  
Wilco Jacobs ◽  
Marinus de Kleuver ◽  
David W Polly ◽  
...  
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Classification System ◽  
Methodological Quality ◽  
Literature Search ◽  
Adult Spinal Deformity ◽  
Classification Systems ◽  
Systematic Literature Search ◽  
Patient Profile

Abstract BACKGROUND Existing adult spinal deformity (ASD) classification systems are based on radiological parameters but management of ASD patients requires a holistic approach. A comprehensive clinically oriented patient profile and classification of ASD that can guide decision-making and correlate with patient outcomes is lacking. OBJECTIVE To perform a systematic review to determine the purpose, characteristic, and methodological quality of classification systems currently used in ASD. METHODS A systematic literature search was conducted in MEDLINE, EMBASE, CINAHL, and Web of Science for literature published between January 2000 and October 2018. From the included studies, list of classification systems, their methodological measurement properties, and correlation with treatment outcomes were analyzed. RESULTS Out of 4470 screened references, 163 were included, and 54 different classification systems for ASD were identified. The most commonly used was the Scoliosis Research Society-Schwab classification system. A total of 35 classifications were based on radiological parameters, and no correlation was found between any classification system levels with patient-related outcomes. Limited evidence of limited quality was available on methodological quality of the classification systems. For studies that reported the data, intraobserver and interobserver reliability were good (kappa = 0.8). CONCLUSION This systematic literature search revealed that current classification systems in clinical use neither include a comprehensive set of dimensions relevant to decision-making nor did they correlate with outcomes. A classification system comprising a core set of patient-related, radiological, and etiological characteristics relevant to the management of ASD is needed.

scholarly journals User involvement in adolescents’ mental healthcare: protocol for a systematic review

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e018800
Author(s):  
Petter Viksveen ◽  
Stig Erlend Bjønness ◽  
Siv Hilde Berg ◽  
Nicole Elizabeth Cardenas ◽  
Julia Rose Game ◽  
...  
Keyword(s):  
Systematic Review ◽  
Critical Appraisal ◽  
Research Evidence ◽  
Data Extraction ◽  
Mental Healthcare ◽  
User Involvement ◽  
Cochrane Collaboration ◽  
Research Literature ◽  
Primary Data ◽  
Evaluation Approach

IntroductionUser involvement has become a growing importance in healthcare. The United Nations state that adolescents have a right to be heard, and user involvement in healthcare is a legal right in many countries. Some research provides an insight into the field of user involvement in somatic and mental healthcare for adults, but little is known about user involvement in adolescents’ mental healthcare, and no overview of the existing research evidence exists.Methods and analysisThe aim of this systematic review is to provide an overview of existing research reporting on experiences with and the effectiveness and safety issues associated with user involvement for adolescents’ mental healthcare at the individual and organisational level. A systematic literature search and assessment of published research in the field of user involvement in adolescents’ mental healthcare will be carried out. Established guidelines will be used for data extraction (Cochrane Collaboration guidelines, Strengthening the Reporting of Observational studies in Epidemiology and Critical Appraisal Skills Programme (CASP)), critical appraisal (Cochrane Collaboration guidelines and Pragmatic-Explanatory Continuum Indicator Summary) and reporting of results (Preferred Reporting Items for Systematic reviews and Meta-Analyses, Consolidated Standards of Reporting Trials and CASP). Confidence in the research evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. Adolescents are included as coresearchers for the planning and carrying out of this systematic review. This systematic review will provide an overview of the existing research literature and thereby fill a knowledge gap. It may provide various stakeholders, including decision-makers, professionals, individuals and their families, with an overview of existing knowledge in an underexplored field of research.Ethics and disseminationEthics approval is not required for this systematic review as we are not collecting primary data. The results will be published in a peer-reviewed journal and at conference presentations and will be shared with stakeholder groups.

Evolution of Hotel Classification System in Russian Federation

2021 ◽  
Vol 12 (1) ◽  
pp. 277
Author(s):  
Dmitry Aleksandrovich KOZLOV
Keyword(s):  
Russian Federation ◽  
Classification System ◽  
State Standards ◽  
Classification Systems ◽  
International Standards ◽  
Economic Activities ◽  
World Tourism Organization ◽  
The Russian Federation ◽  
Tourism Organization

The main aim of this paper is to analyze the approaches to the system of classification of accommodation facilities in the Russian Federation. The United Nations World Tourism Organization pays great attention to the unification of classification systems for accommodation facilities in all countries of the world, issuing appropriate recommendations on tourism statistics systems, classification of economic activities, as well as criteria for interregional harmonization. In the Russian Federation, there are a number of laws, regulations, state standards, building and sanitary norms and rules concerning the classification of accommodation facilities. They are so imperfect that they have to be revised almost annually or even several times a year. The general statistics of accommodation facilities currently do not correspond to world recommendations. The classification system needs to be revised and brought into line with international standards as much as possible.

scholarly journals Classification and treatment of endothermal heat-induced thrombosis: Recommendations from the American Venous Forum and the Society for Vascular Surgery This Practice Guidelines document has been co-published in Phlebology [DOI: 10.1177/0268355520953759] and Journal of Vascular Surgery: Venous and Lymphatic Disorders [DOI: 10.1016/j.jvsv.2020.06.008]. The publications are identical except for minor stylistic and spelling differences in keeping with each journal’s style. The contribution has been published under a Attribution-Non Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0), (https://creativecommons.org/licenses/by-nc-nd/4.0/).

2020 ◽  
pp. 026835552095375
Author(s):  
Lowell S. Kabnick ◽  
Mikel Sadek ◽  
Haraldur Bjarnason ◽  
Dawn M. Coleman ◽  
Ellen D. Dillavou ◽  
...  
Keyword(s):  
Vascular Surgery ◽  
Classification System ◽  
Treatment Guidelines ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Duplex Ultrasound ◽  
Classification Systems ◽  
The Body ◽  
The Novel

The American Venous Forum (AVF) and the Society for Vascular Surgery set forth these guidelines for the management of endothermal heat-induced thrombosis (EHIT). The guidelines serve to compile the body of literature on EHIT and to put forth evidence-based recommendations. The guidelines are divided into the following categories: classification of EHIT, risk factors and prevention, and treatment of EHIT. One major feature is to standardize the reporting under one classification system. The Kabnick and Lawrence classification systems are now combined into the AVF EHIT classification system. The novel classification system affords standardization in reporting but also allows continued combined evaluation with the current body of literature. Recommendations codify the use of duplex ultrasound for the diagnosis of EHIT. Risk factor assessments and methods of prevention including mechanical prophylaxis, chemical prophylaxis, and ablation distance are discussed. Treatment guidelines are tailored to the AVF EHIT class (ie, I, II, III, IV). Reference is made to the use of surveillance, antiplatelet therapy, and anticoagulants as deemed indicated, and the recommendations incorporate the use of the novel direct oral anticoagulants. Last, EHIT management as it relates to the great and small saphenous veins is discussed.

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