title: Cyst index: a nonpredictor of simple bone cyst fracture.
abstract: OBJECTIVE
  Treatment is indicated for simple bone cysts (SBC) with high risk of fracture. The cyst index was described as a method to determine if a cyst is at high risk or low risk of fracture.
  
  
  METHODS
  The cyst index of 32 femoral and humeral SBCs was determined by 8 reviewers. The risk group cyst index was compared with whether a fracture took place. Sensitivities, specificities, and positive and negative predictive values were calculated across varying cutoff levels. Intraobserver and interobserver reliability testing for 10 cysts was made.
  
  
  RESULTS
  Receiver operator curves demonstrate that no cutoff value gave an acceptable level of both sensitivity and specificity. The mean value for the cyst index was significantly different for different observers (P < 0.05).
  
  
  CONCLUSIONS
  This study does not validate the cyst index to be an accurate predictor of fracture. The test has low intraobserver and interobserver reliability.
  
  
  CONCLUSIONS
  The cyst index cannot reliably discriminate between the patients that will fracture and those that will not.
authors.affiliation: John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Vasconcellos
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Yandow
authors.forename: Aimee M
authors.initials: AM
authors.lastname: Grace
authors.forename: Burt M
authors.initials: BM
authors.lastname: Moritz
authors.forename: Lisa D
authors.initials: LD
authors.lastname: Marley
authors.forename: Ramona R
authors.initials: RR
authors.lastname: Fillman
mesh_terms: D001845:Bone Cysts / Q000150:complications*; D002648:Child; D005264:Femoral Fractures / Q000209:etiology*; D006801:Humans; D006810:Humeral Fractures / Q000209:etiology*; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity