Tomita及改良Tokuhashi结合脊柱肿瘤不稳评分在脊柱转移瘤患者治疗决策中的可信度和可重复性研究

发布时间：2018-04-16 08:06

本文选题：脊柱转移瘤 + Tomita评分　；参考：《中国脊柱脊髓杂志》2017年09期

【摘要】：目的 :分析Tomita评分结合脊柱肿瘤不稳评分(spinal instability neoplastic score,SINS)和改良Tokuhashi评分结合SINS评分用于脊柱转移瘤患者治疗决策的可信度和可重复性,评价两套评分系统临床运用价值。方法:3名具有一定临床经验的脊柱外科医生对41例脊柱转移瘤患者进行回顾性分析。这3名脊柱外科医生用Tomita评分、改良Tokuhashi评分、SINS评分对每位患者进行评分,并运用改良Tokuhashi结合SINS评分及Tomita结合SINS评分决定患者的治疗方案。间隔20天后对上述病例进行重复分析,分析观察者间一致性和观察者内一致性。结果:Tomita结合SINS评分用于治疗决策时,平均观察者间一致性Kappa值为0.78(0.75~0.81),平均观察者内一致性Cronbach′sα系数为0.79(0.77~0.82)。改良Tokuhashi结合SINS评分用于治疗决策时,平均观察者间一致性Kappa值为0.68(0.65~0.72),平均观察者内一致性Cronbach′sα系数为0.73(0.72~0.75)。有17.9%的患者在两组系统评估后而得出不同治疗方案。结论:Tomita结合SINS评分和改良Tokuhashi结合SINS评分均具有较好的可信度和可重复性。
[Abstract]:Objective: to analyze the reliability and repeatability of Tomita score combined with instability neoplastic score score and modified Tokuhashi score combined with SINS score in the treatment of spinal metastases, and to evaluate the clinical application value of the two scoring systems.Methods 41 patients with spinal metastases were retrospectively analyzed by 3 spinal surgeons with certain clinical experience.The three spinal surgeons scored each patient with Tomita score, modified Tokuhashi score and sins score. The modified Tokuhashi combined with SINS score and Tomita combined with SINS score were used to determine the treatment plan of the patients.The two cases were analyzed repeatedly after 20 days interval to analyze the inter-observer and intra-observer consistency.Results the mean inter-observer consistency (Kappa) and intra-observer consistency (Cronbach's 伪) were 0.78 / 0.75 / 0.81 and 0.79 / 0.77 / 0.82 / L, respectively.When modified Tokuhashi and SINS score were used in therapeutic decision-making, the mean inter-observer consistency (Kappa) was 0.68 卤0.65 卤0.72 and the average intra-observer consistency Cronbach's 伪 coefficient was 0.730.72 卤0.75.17.9% of the patients received different treatments after systematic evaluation in both groups.Conclusion both the SINS score and the modified Tokuhashi score have good reliability and reproducibility.
【作者单位】：哈尔滨医科大学附属第二医院脊柱外科;
【分类号】：R738.1

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