Concordância intra e interobservador com relação ao sistema de classificação de Walch para artrose da articulação do ombro

Abstract

Objective To evaluate the inter- and intraobserver agreement regarding the Walch classification system for shoulder arthritis. Methods Computed tomography scans of the shoulder joint of adult patients were selected between 2012 and 2016, and they were classified by physicians with different levels of expertise in orthopedics. The images were examined at three different times, and the analyses were evaluated by the Fleiss Kappa index to verify the intra- and interobserver agreement. Results The Kappa index for the intraobserver agreement ranged from 0.305 to 0.545. The inter-observer agreement was very low at the end of the three evaluations (κ = 0.132). Conclusion The intraobserver agreement regarding the modified Walch classification varied from moderate to poor. The interobserver agreement was low.

The Evolution of the Walch Classification for Primary Glenohumeral Arthritis

“…However, since the modified Walch classification was published, several authors have reported lower kappa scores for both interobserver and intraobserver reliabilities than Bercik et al, suggesting that the reliability may not be as high as initially predicted. 29,30…”

“…Although some evidence supports moderate reliability of the modified Walch classification, 33 there remains evidence indicating poor reproducibility using this classification. 29,30 Low reproducibility implies imperfect understanding of pathology that may influence treatment plans and interpretations of clinical outcomes. 9 Thus, we predict that the classification of glenohumeral osteoarthritis will transition toward simple numerical values that describe the precise amount and direction of subluxation, amount of glenoid erosion, and degrees of inclination.…”