{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T01:13:10Z","timestamp":1791767590835,"version":"4.3.4"},"reference-count":23,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T00:00:00Z","timestamp":1742774400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T00:00:00Z","timestamp":1742774400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"AO Spine through the AO Spine Knowledge Forum Trauma, a focused group of international Trauma experts."},{"name":"AO Spine is a clinical division of the AO Foundation, which is an independent medically-guided not-for-profit organization."},{"name":"Study support was provided directly through AO Network Clinical Research"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2025,11]]},"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>A cornerstone of classification systems is good reliability amongst different groups of classification users. Thus, the aim of this international validation study was to assess the reliability of the new AO Spine DGOU Osteoporotic Fracture Classification (OF classification) stratified by surgical specialty, work-setting, work-experience, and trauma center level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>320 spine surgeons were asked to rate 27 cases according to the OF classification at 2 time points, 4\u00a0weeks apart (assessment 1 and 2) in this online-webinar based validation process. The kappa statistic (\u03ba) was calculated to assess the inter-observer reliability and the intra-rater reproducibility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 7798 (90.3%) ratings were recorded in assessment 1 and 6621 (76.6%) ratings in assessment 2. Global inter-rater reliability was moderate in both assessments (\u03ba = 0.57; \u03ba = 0.58). Participants with a work-experience of &gt;20\u00a0years showed the highest inter-rater agreement in both assessments globally (\u03ba = 0.65; \u03ba = 0.67). Participants from a level-1 trauma center showed the highest agreement (\u03ba = 0.58), whereas participants working at a tertiary trauma center showed higher grade of agreement in the second assessment (\u03ba = 0.66). Participants working in academia showed the highest agreement in assessment 2 (\u03ba = 0.6). Surgeons with academic background and surgeons employed by a hospital showed substantial intra-rater agreement in the second assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The AO Spine-DGOU Osteoporotic Fracture Classification showed moderate to substantial inter-rater agreement as well as intra-rater reproducibility regardless of work-setting, surgical experience, level of trauma center and surgical specialty.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682251331945","type":"journal-article","created":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T09:06:52Z","timestamp":1742807212000},"page":"3764-3774","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Validation of the AOSpine-DGOU Osteoporotic Fracture Classification \u2013 Effect of Surgical Experience, Surgical Specialty, Work-Setting and Trauma Center Level on Reliability and Reproducibility"],"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\/0000-0002-4649-0610","authenticated-orcid":false,"given":"Sebastian Frederick","family":"Bigdon","sequence":"additional","affiliation":[{"name":"University Hospital Bern"},{"name":"University of Bern"}],"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"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2645-0483","authenticated-orcid":false,"given":"Andrei Fernandes","family":"Joaquim","sequence":"additional","affiliation":[{"name":"State University of Campinas"}],"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":"Marcel","family":"Dvorak","sequence":"additional","affiliation":[{"name":"Vancouver General Hospital"},{"name":"University of British Columbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Schroeder","sequence":"additional","affiliation":[{"name":"Thomas Jefferson University 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":"Richard","family":"Bransford","sequence":"additional","affiliation":[{"name":"Harborview Medical Center"},{"name":"University of Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5320-5638","authenticated-orcid":false,"given":"Lorin Michael","family":"Benneker","sequence":"additional","affiliation":[{"name":"University of Bern"}],"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"}]},{"name":"on behalf of the AO Spine-DGOU International Validation 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Development of online technique for international validation of the AO spine subaxial injury classification system. Glob Spine J. 2022;14:21925682221098967.","journal-title":"Glob Spine J"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.1037\/h0031619"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2022.08.005"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-022-07467-6"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2022.02.029"},{"key":"e_1_3_6_20_2","first-page":"219256822412881","article-title":"AO spine-DGOU osteoporotic fracture classification system: internal validation by the AO spine knowledge Forum trauma","author":"Scherer J","year":"2024","unstructured":"Scherer J, Joaquim A, Vaccaro A, et al. AO spine-DGOU osteoporotic fracture classification system: internal validation by the AO spine knowledge Forum trauma. 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