title: Low agreement among 24 doctors using the Neer-classification; only moderate agreement on displacement, even between specialists.
abstract: Twenty-four orthopaedic surgeons classified 42 pairs of radiographs according to the Neer system for proximal humeral fractures. Mean kappa value for inter-observer agreement was 0.27 (95% CI 0.26-0.28) with no clinically significant difference between orthopaedic residents ( n=9), fellows ( n=6) and specialists ( n=9). Mean kappa for agreement of displacement versus non-displacement was 0.41 (95% CI 0.39-0.43) overall, and 0.50 (95% CI 0.45-0.56) within the specialist group. The agreement found in our study is unsatisfactory from a clinical perspective.
authors.affiliation: Department of Medical Philosophy and Clinical Theory, University of Copenhagen, Panum Institute, Blegdamsvej 3, 2200 Copenhagen N, Denmark. s.brorson@medphil.ku.dk
authors.forename: S
authors.initials: S
authors.lastname: Brorson
authors.forename: J
authors.initials: J
authors.lastname: Bagger
authors.forename: A
authors.initials: A
authors.lastname: Sylvest
authors.forename: A
authors.initials: A
authors.lastname: Hróbjartsson
mesh_terms: D016001:Confidence Intervals; D006801:Humans; D006810:Humeral Fractures / Q000145:classification* / Q000000981:diagnostic imaging*; D015588:Observer Variation; D009985:Orthopedics / Q000379:methods; D011859:Radiography; D011871:Radiology / Q000379:methods