scholarly journals Validity of classification of distal radial fractures in the Swedish fracture register

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Malena Bergvall ◽  
Carl Bergdahl ◽  
Carl Ekholm ◽  
David Wennergren
Keyword(s):  
Gold Standard ◽  
Reference Group ◽  
Observer Agreement ◽  
Distal Radial Fractures ◽  
Young Males ◽  
Small Peak ◽  
National Quality ◽  
Fracture Register ◽  
Standard Classification

Abstract Background Distal radial fractures (DRF) are one of the most common fractures with a small peak in incidence among young males and an increasing incidence with age among women. The reliable classification of fractures is important, as classification provides a framework for communicating effectively on clinical cases. Fracture classification is also a prerequisite for data collection in national quality registers and for clinical research. Since its inception in 2011, the Swedish Fracture Register (SFR) has collected data on more than 490,000 fractures. The attending physician classifies the fracture according to the AO/OTA classification upon registration in the SFR. Previous studies regarding the classification of distal radial fractures (DRF) have shown difficulties in inter- and intra-observer agreement. This study aims to assess the accuracy of the registration of DRF in adults in the SFR as it is carried out in clinical practice. Methods A reference group of three experienced orthopaedic trauma surgeons classified 128 DRFs, randomly retrieved from the SFR, at two classification sessions 6 weeks apart. The classification the reference group agreed on was regarded as the gold standard classification for each fracture. The accuracy of the classification in the SFR was defined as the agreement between the gold standard classification and the classification in the SFR. Inter- and intra-observer agreement was evaluated and the degree of agreement was calculated as Cohen’s kappa. Results The accuracy of the classification of DRF in the SFR was kappa = 0.41 (0.31–0.51) for the AO/OTA subgroup/group and kappa = 0.48 (0.36–0.61) for the AO/OTA type. This corresponds to moderate agreement. Inter-observer agreement ranged from kappa 0.22–0.48 for the AO/OTA subgroup/group and kappa 0.48–0.76 for the AO/OTA type. Intra-observer agreement ranged from kappa 0.52–0.70 for the AO/OTA subgroup/group and kappa 0.71–0.76 for the AO/OTA type. Conclusions The study shows moderate accuracy in the classification of DRF in the SFR. Although the degree of accuracy for DRF appears to be lower than for other fracture locations, the accuracy shown in the current study is similar to that in previous studies of DRF.

scholarly journals Surveillance of atypical femoral fractures in a nationwide fracture register

2022 ◽  
Vol 93 ◽  
pp. 229-233
Author(s):  
Hans Peter Bögl ◽  
Georg Zdolsek ◽  
Lukas Barnisin ◽  
Michael Möller ◽  
Jörg Schilcher
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
Femoral Fractures ◽  
Study Cohort ◽  
Atypical Femoral Fractures ◽  
User Classification ◽  
Radiology Reports ◽  
Fracture Register ◽  
Standard Classification

Background and purpose — To continuously assess the incidence of atypical femoral fractures (AFFs) in the population is important, to allow the evaluation of the risks and benefits associated with osteoporosis treatment. Therefore, we investigated the possibility to use the Swedish Fracture Register (SFR) as a surveillance tool for AFFs in the population and to explore means of improvement. Patients and methods — All AFF registrations in the SFR from January 1, 2015 to December 31, 2018 were enrolled in the study. For these patients, radiographs were obtained and combined with radiographs from 176 patients with normal femoral fractures, to form the study cohort. All images were reviewed and classified into AFFs or normal femur fractures by 2 experts in the field (gold-standard classification) and 1 orthopedic resident educated on the specific radiographic features of AFF (educated-user classification). Furthermore, we estimated the incidence rate of AFFs in the population captured by the register through comparison with a previous cohort and calculated the positive predictive value (PPV) and, where possible, the inter-observer agreement (Cohen’s kappa) between the different classifications. Results — Of the 178 available patients with AFF in the SFR, 104 patients were classified as AFF using the goldstandard classification, and 89 using the educated-user classification. The PPV increased from 0.58 in the SFR classification to 0.93 in the educated-user classification. The interobserver agreement between the gold-standard classification and the educated-user classification was 0.81. Interpretation — With a positive predictive value of 0.58 the Swedish Fracture Register outperforms radiology reports and reports to the Swedish Medical Products Agency on adverse drug reactions as a diagnostic tool to identify atypical femoral fractures.

scholarly journals Application of MRI for the Diagnosis of Neoplasms

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Ewa Bejer-Oleńska ◽  
Michael Thoene ◽  
Andrzej Włodarczyk ◽  
Joanna Wojtkiewicz
Keyword(s):  
Benign Neoplasms ◽  
Young Males ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Mri Scans ◽  
International Statistical Classification ◽  
The Central Nervous System ◽  
Spss Software ◽  
The Brain

Aim. The aim of the study was to determine the most commonly diagnosed neoplasms in the MRI scanned patient population and indicate correlations based on the descriptive variables. Methods. The SPSS software was used to determine the incidence of neoplasms within the specific diagnoses based on the descriptive variables of the studied population. Over a five year period, 791 patients and 839 MRI scans were identified in neoplasm category (C00-D48 according to the International Statistical Classification of Diseases and Related Health Problems ICD-10). Results. More women (56%) than men (44%) represented C00-D48. Three categories of neoplasms were recorded. Furthermore, benign neoplasms were the most numerous, diagnosed mainly in patients in the fifth decade of life, and included benign neoplasms of the brain and other parts of the central nervous system. Conclusions. Males ≤ 30 years of age with neoplasms had three times higher MRI scans rate than females of the same age group; even though females had much higher scans rate in every other category. The young males are more often selected for these scans if a neoplasm is suspected. Finally, the number of MRI-diagnosed neoplasms showed a linear annual increase.

Clinical value of classification of venous malformations with contrast-enhanced MR Angiography

2016 ◽  
Vol 32 (9) ◽  
pp. 628-633 ◽  
Author(s):  
Ahmed Abdel Khalek Abdel Razek ◽  
Germeen Ashmalla Albair ◽  
Sieza Samir
Keyword(s):  
Mr Angiography ◽  
Treatment Plan ◽  
Venous Malformation ◽  
Observer Agreement ◽  
Type I ◽  
Venous Malformations ◽  
Single Measure ◽  
Intra Class Correlation ◽  
Contrast Enhanced

Aim To classify venous malformations based on contrast-enhanced MR angiography that may serve as a basis for treatment plan. Patients and methods A retrospective analysis was performed in 58 patients with venous malformations who underwent contrast-enhanced MR angiography. Venous malformations were classified according to their venous drainage into: type I, isolated malformation without peripheral drainage; type II, malformation that drains into normal veins; type III, malformation that drains into dilated veins; and type IV, malformation that represents dysplastic venous ectasia. Image analysis was done by two reviewers. Intra and inter-observer agreement of both reviewers and intra-class correlation was done. Results The intra-observer agreement of contrast-enhanced MR angiography classification of venous malformations was excellent for the first reviewer ( k = 0.83, 95% CI = 0.724–0.951, P = 0.001) and substantial for the second reviewer ( K = 0.79, 95% CI = 0.656-0.931, P = 0.001). The inter-observer agreement of contrast-enhanced MR angiography classification of venous malformations was excellent for both reviewers at the first time ( K = 0.96, 95% CI = 0.933–1.000, P = 0.001) and second time ( k = 0.81, 95% CI = 0.678–0.942, P = 0.001). There was high intra-class correlation of both reviewers for single measure ( ICC = 0.85, 95% CI = 0.776–0.918, P = 0.001) and for average measures ( ICC = 0.96, 95% CI = 0.933–0.978, P = 0.001). Conclusion Contrast-enhanced MR angiography classification of venous malformations may be a useful, simple and reliable tool to accurately classify venous malformation and this topographic classification helps for better management strategy.

The relation between AO-classification of distal radial fractures and bone mineral density

Injury ◽  
2013 ◽  
Vol 44 (11) ◽  
pp. 1657-1658 ◽  
Author(s):  
Gijs de Klerk ◽  
J. Han Hegeman ◽  
Henk Jan ten Duis
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Mineral Density ◽  
Distal Radial Fractures ◽  
Ao Classification

Classifying Predicates and Languages

1997 ◽  
Vol 08 (01) ◽  
pp. 15-41 ◽  
Author(s):  
Carl H. Smith ◽  
Rolf Wiehagen ◽  
Thomas Zeugmann
Keyword(s):  
Learning Theory ◽  
Classification Problems ◽  
Attention In Learning ◽  
Recursive Functions ◽  
Standard Classification ◽  
Resource Bound ◽  
Multi Classification

The present paper studies a particular collection of classification problems, i.e., the classification of recursive predicates and languages, for arriving at a deeper understanding of what classification really is. In particular, the classification of predicates and languages is compared with the classification of arbitrary recursive functions and with their learnability. The investigation undertaken is refined by introducing classification within a resource bound resulting in a new hierarchy. Furthermore, a formalization of multi-classification is presented and completely characterized in terms of standard classification. Additionally, consistent classification is introduced and compared with both resource bounded classification and standard classification. Finally, the classification of families of languages that have attracted attention in learning theory is studied, too.

scholarly journals Inter- and intra-observer agreement on Miller’s classification of gingival tissue recessions

Odontology ◽  
2014 ◽  
Vol 103 (3) ◽  
pp. 292-300 ◽  
Author(s):  
Kristina Bertl ◽  
Dorothea Ruckenbauer ◽  
Michael Müller-Kern ◽  
Gerlinde Durstberger ◽  
Stefan Lettner ◽  
...  
Keyword(s):  
Observer Agreement ◽  
Gingival Tissue

scholarly journals Towards a better understanding of the low recall of insertion variants with short-read based variant callers

2020 ◽  
Author(s):  
Wesley Delage ◽  
Julien Thevenon ◽  
Claire Lemaitre
Keyword(s):  
Gold Standard ◽  
Insertion Site ◽  
Structural Variants ◽  
Genomic Context ◽  
Breakpoint Junction ◽  
Short Read ◽  
Depth Analysis ◽  
Long Read ◽  
The Impact

AbstractSince 2009, numerous tools have been developed to detect structural variants (SVs) using short read technologies. Insertions >50 bp are one of the hardest type to discover and are drastically underrepresented in gold standard variant callsets. The advent of long read technologies has completely changed the situation. In 2019, two independent cross technologies studies have published the most complete variant callsets with sequence resolved insertions in human individuals. Among the reported insertions, only 17 to 37% could be discovered with short-read based tools. In this work, we performed an in-depth analysis of these unprecedented insertion callsets in order to investigate the causes of such failures. We have first established a precise classification of insertion variants according to four layers of characterization: the nature and size of the inserted sequence, the genomic context of the insertion site and the breakpoint junction complexity. Because these levels are intertwined, we then used simulations to characterize the impact of each complexity factor on the recall of several SV callers. Simulations showed that the most impacting factor was the insertion type rather than the genomic context, with various difficulties being handled differently among the tested SV callers, and they highlighted the lack of sequence resolution for most insertion calls. Our results explain the low recall by pointing out several difficulty factors among the observed insertion features and provide avenues for improving SV caller algorithms and their [email protected]

scholarly journals Fracture incidence in adults in relation to age and gender: A study of 27,169 fractures in the Swedish Fracture Register in a well-defined catchment area

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244291
Author(s):  
Camilla Bergh ◽  
David Wennergren ◽  
Michael Möller ◽  
Helena Brisby
Keyword(s):  
Catchment Area ◽  
Fracture Incidence ◽  
Care Seeking ◽  
Age And Gender ◽  
Orthopaedic Care ◽  
Quality Register ◽  
Accessible Information ◽  
National Quality ◽  
Fracture Register ◽  
And Gender

Studies on fracture incidence have mostly been based on retrospectively registered data from local hospital databases. The Swedish Fracture Register (SFR) is a national quality register collecting data prospectively on fractures, at the time of care-seeking. In the present study the incidence of all different fractures, regardless of location, in adults’ ≥ 16 years treated at the only care provider for patients with fractures within a catchment area of approximately 550,000 inhabitants, during 2015‒2018 are described. Age, gender, and fracture location (according to AO/OTA classification) was used for the analyses and presentation of fracture incidences. During the 4-year study period, 23,917 individuals sustained 27,169 fractures. The mean age at fracture was 57.9 years (range 16‒105 years) and 64.5% of the fractures occurred in women. The five most common fractures accounted for more than 50% of all fractures: distal radius, proximal femur, ankle, proximal humerus, and metacarpal fractures. Seven fracture incidence distribution groups were created based on age- and gender-specific incidence curves, providing visual and easily accessible information on fracture distribution. This paper reports on incidence of all fracture locations based on prospectively collected data in a quality register. The knowledge on fracture incidence related to age and gender may be of importance for the planning of orthopaedic care, involving both in- and out-patients as well as allocating surgical resources. Further, this might be useful for organizing preventive measures, especially in countries with similar socioeconomic structure and fracture burden.

scholarly journals Introduction to the History and Current Status of Evidence-Based Korean Medicine: A Unique Integrated System of Allopathic and Holistic Medicine

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Chang Shik Yin ◽  
Seong-Gyu Ko
Keyword(s):  
Evidence Based Medicine ◽  
Holistic Medicine ◽  
National Standard ◽  
Evidence Based ◽  
Korean Medicine ◽  
Classification Of Diseases ◽  
Recent Developments ◽  
Standard Classification ◽  
Based Medicine

Objectives. Korean medicine, an integrated allopathic and traditional medicine, has developed unique characteristics and has been active in contributing to evidence-based medicine. Recent developments in Korean medicine have not been as well disseminated as traditional Chinese medicine. This introduction to recent developments in Korean medicine will draw attention to, and facilitate, the advancement of evidence-based complementary alternative medicine (CAM).Methods and Results. The history of and recent developments in Korean medicine as evidence-based medicine are explored through discussions on the development of a national standard classification of diseases and study reports, ranging from basic research to newly developed clinical therapies. A national standard classification of diseases has been developed and revised serially into an integrated classification of Western allopathic and traditional holistic medicine disease entities. Standard disease classifications offer a starting point for the reliable gathering of evidence and provide a representative example of the unique status of evidence-based Korean medicine as an integration of Western allopathic medicine and traditional holistic medicine.Conclusions. Recent developments in evidence-based Korean medicine show a unique development in evidence-based medicine, adopting both Western allopathic and holistic traditional medicine. It is expected that Korean medicine will continue to be an important contributor to evidence-based medicine, encompassing conventional and complementary approaches.

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