title: Is surgeons' experience important on intra- and inter-observer reliability of classifications used for adult femoral neck fracture?
abstract: OBJECTIVE
  To evaluate whether surgeons' experience affect inter- and intra-observer reliability among mostly used classification systems for femoral neck fractures.
  
  
  METHODS
  A power point presentation was prepared with 107 slides which were antero-posterior radiographs of each femoral neck fracture. Five residents, 5 orthopaedic surgeons and 5 senior orthopaedic surgeons reviewed this presentation and classified the fractures according to Garden, Pauwels and AO classifications. The order of the slides was changed and reviews were repeated after 3 months. Fleiss kappa and intraclass correlation coefficient values were calculated to evaluate inter and intra-observer reliability.
  
  
  RESULTS
  Garden and AO classifications' inter-observer reliabilities were similar and higher than Pauwels classification. Among three experience groups, the inter-observer reliability for Garden classification was highest in senior surgeon group, the interobserver reliability for AO classification was highest in surgeon group, and interobserver reliability of Pauwels classification was highest in low experienced groups (residents and surgeons). Intra-observer reliability was highest for Garden and lowest for Pauwels classifications. Surgical experience was found to be not effective for intraobserver reliability.
  
  
  CONCLUSIONS
  Both Garden and AO classifications were more reliable than Pauwels classification. Surgical experience was not significantly important on these three classification systems' evaluation.
  
  
  METHODS
  Level IV, Diagnostic study.
authors.affiliation: Tepecik Eğitim ve Araştırma Hastanesi, İzmir, Turkey. Electronic address: draliturgutort@yahoo.com.tr.
authors.forename: Ali
authors.initials: A
authors.lastname: Turgut
authors.affiliation: Tepecik Eğitim ve Araştırma Hastanesi, İzmir, Turkey.
authors.forename: Mert
authors.initials: M
authors.lastname: Kumbaracı
authors.affiliation: Tepecik Eğitim ve Araştırma Hastanesi, İzmir, Turkey.
authors.forename: Önder
authors.initials: Ö
authors.lastname: Kalenderer
authors.affiliation: Tepecik Eğitim ve Araştırma Hastanesi, İzmir, Turkey.
authors.forename: Gökhan
authors.initials: G
authors.lastname: İlyas
authors.affiliation: Tepecik Eğitim ve Araştırma Hastanesi, İzmir, Turkey.
authors.forename: Tayfun
authors.initials: T
authors.lastname: Bacaksız
authors.affiliation: Tepecik Eğitim ve Araştırma Hastanesi, İzmir, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Karapınar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002983:Clinical Competence; D005260:Female; D005265:Femoral Neck Fractures / Q000145:classification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011859:Radiography; D015203:Reproducibility of Results; D066231:Surgeons / Q000592:standards*; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Classifications; Experience; Femoral neck fracture; Reliability