title: Evaluation of the Singh index for measuring osteoporosis.
abstract: We studied the reliability of the Singh classification of trabecular bone structure in the proximal femur as a measure of osteoporosis, using kappa statistics. Radiographs of fractures of the femoral neck or trochanteric region in 80 consecutive patients were assessed by six observers. The interobserver variation was large; only three of 72 radiographs were given the same classification by all six observers and the kappa values ranged from 0.15 to 0.54. the intraobserver variation showed substantial strength of agreement; kappa values ranged from 0.63 to 0.88. In 77 patients dual-energy X-ray absorptiometry was used to measure bone mineral density. The results were compared with those of the Singh classification: we found no correlation.
authors.affiliation: Department of Radiology Diakonessehuis, Ultrecht, The Netherlands.
authors.forename: V C
authors.initials: VC
authors.lastname: Koot
authors.forename: S M
authors.initials: SM
authors.lastname: Kesselaer
authors.forename: G J
authors.initials: GJ
authors.lastname: Clevers
authors.forename: P
authors.initials: P
authors.lastname: de Hooge
authors.forename: T
authors.initials: T
authors.lastname: Weits
authors.forename: C
authors.initials: C
authors.lastname: van der Werken
mesh_terms: D015502:Absorptiometry, Photon; D000704:Analysis of Variance; D005265:Femoral Neck Fractures / Q000209:etiology*; D006801:Humans; D008875:Middle Aged; D015588:Observer Variation; D010024:Osteoporosis / Q000145:classification* / Q000150:complications / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D015203:Reproducibility of Results; D012720:Severity of Illness Index