{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T12:12:14Z","timestamp":1793967134493,"version":"4.8.0"},"reference-count":18,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2024,9,27]],"date-time":"2024-09-27T00:00:00Z","timestamp":1727395200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,9,27]],"date-time":"2024-09-27T00:00:00Z","timestamp":1727395200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"AO Spine Knowledge Forum Trauma"},{"DOI":"10.13039\/501100001702","name":"AO Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001702","id-type":"DOI","asserted-by":"crossref"}]},{"name":"AO Network Clinical Research"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Cross-sectional survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Injury classifications are important tools to identify fracture patterns, guide treatment-decisions and aid to identify optimal treatment plans. The AO Spine-DGOU Osteoporotic Fracture (OF) classification system was developed, and the aim of this study was to assess the reliability of this new classification system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>23 Members of the AO Spine Knowledge Forum Trauma participated in the validation process. Participants were asked to rate 33 cases according to the OF classification at 2 time points, 4\u00a0weeks apart (assessment 1 and 2). The kappa statistic (\u03ba) was calculated to assess inter-observer reliability and intra-rater reproducibility. The gold master key for each case was determined by approval of at least 5 out of 7 members of the DGOU.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1386 ratings (21 raters) were performed. The overall inter-rater agreement was moderate with a combined kappa statistic for the OF classification of 0.496 in assessment 1 and 0.482 in assessment 2. The combined percentage of correct ratings (compared to gold-standard) in assessment 1 was 71.4% and 67.4% in assessment 2. The average intra-rater reproducibility was substantial (\u03ba = 0.74, median 0.76, range 0.55 to 1.00, SD 0.13) for the assessed fracture types.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The assessed overall inter-rater reliability was moderate and substantial in some instances. The average intra-rater reproducibility is substantial. It seems that appropriate training of the classification system can enhance inter- and intra-rater reliability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682241288187","type":"journal-article","created":{"date-parts":[[2024,9,27]],"date-time":"2024-09-27T03:33:03Z","timestamp":1727407983000},"page":"2152-2157","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":17,"title":["AO Spine-DGOU Osteoporotic Fracture Classification System: Internal Validation by the AO Spine Knowledge Forum Trauma"],"prefix":"10.1177","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8943-5817","authenticated-orcid":false,"given":"Julian","family":"Scherer","sequence":"first","affiliation":[{"name":"University of Cape Town"},{"name":"University Hospital of Zurich"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2645-0483","authenticated-orcid":false,"given":"Andrei","family":"Joaquim","sequence":"additional","affiliation":[{"name":"State University of Campinas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Vaccaro","sequence":"additional","affiliation":[{"name":"Thomas Jefferson University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5817-4909","authenticated-orcid":false,"given":"Rishi","family":"Kanna","sequence":"additional","affiliation":[{"name":"Ganga Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6177-7145","authenticated-orcid":false,"given":"Mohammad","family":"El-Sharkawi","sequence":"additional","affiliation":[{"name":"Assiut University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiko","family":"Takahata","sequence":"additional","affiliation":[{"name":"Dokkyo Medical University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5221-8288","authenticated-orcid":false,"given":"Mohamed M.","family":"Aly","sequence":"additional","affiliation":[{"name":"Prince Mohammed Bin Abdulaziz Hospital"},{"name":"Mansoura University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5684-7679","authenticated-orcid":false,"given":"Gaston","family":"Camino-Willhuber","sequence":"additional","affiliation":[{"name":"Policina Gipuzkoa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5179-4192","authenticated-orcid":false,"given":"Ulrich","family":"Spiegl","sequence":"additional","affiliation":[{"name":"Klinik M\u00fcnchen Harlaching"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cumhur","family":"Oner","sequence":"additional","affiliation":[{"name":"University Medical Centers"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2152-5725","authenticated-orcid":false,"given":"Jose A.","family":"Canseco","sequence":"additional","affiliation":[{"name":"Thomas Jefferson University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3603-6294","authenticated-orcid":false,"given":"Ratko","family":"Yurac","sequence":"additional","affiliation":[{"name":"University Del Desarrollo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorin Michael","family":"Benneker","sequence":"additional","affiliation":[{"name":"University of Bern"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5732-5402","authenticated-orcid":false,"given":"Eugen Cezar","family":"Popescu","sequence":"additional","affiliation":[{"name":"\u201cProf. N. Oblu\u201d Emergency Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Bransford","sequence":"additional","affiliation":[{"name":"Harborview Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harvinder Singh","family":"Chhabra","sequence":"additional","affiliation":[{"name":"Sri Balaji Action Medical Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Kandziora","sequence":"additional","affiliation":[{"name":"BG Unfallklinik Frankfurt Am Main"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marko H.","family":"Neva","sequence":"additional","affiliation":[{"name":"Tampere University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus John","family":"Schnake","sequence":"additional","affiliation":[{"name":"Malteser Waldkrankenhaus St. Marien Erlangen"},{"name":"Paracelsus Private Medical University Nuremberg"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,9,27]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2005.11.024"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glt092"},{"issue":"3","key":"e_1_3_6_4_2","first-page":"e2020054","article-title":"Towards realization of longer life","volume":"91","author":"Khavinson V","year":"2020","unstructured":"Khavinson V, Popovich I, Mikhailova O. 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