Intra- and interobserver concordance evaluation of Tomita with SINS scoring system and Tokuhashi with SINS scoring system for decision making in spinal metastases

English Keywords:Spinal metastases  Tomita scoring system  Revised Tokuhashi scoring system  SINS scoring system  Intraobserver concordance  Interobserver concordance

English Abstract:

  【Abstract】 Objectives: To investigate the intra- and interobserver concordance of Tomita with spinal instability neoplastic score(SINS) scoring system and Tokuhashi with SINS scoring system in defining the treatment of vertebral metastatic lesions. Methods: Forty-one cases of vertebral metastatic lesions were presented to three spinal surgeons. All cases were evaluated by the three spine surgeons based on Tomita scoring system, revised Tokuhashi scoring system and SINS scoring system. Then the intra- and interobserver concordance was evaluated accordingly. The treatment was also decided by Tomita with SINS scoring system and Tokuhashi with SINS scoring system respectively. The repeated evaluation was employed at 20 days after the first time evaluation. Results: The intraobserver consistency of Tomita with SINS scoring system was 0.78(0.75-0.81), while interobserver consistency validity was 0.79(0.77-0.82). The intraobserver consistency of Tokuhashi with SINS scoring system was 0.68(0.65-0.72), while interobserver consistency was 0.73(0.72-0.75). 17.9% of the cases changed the treatment approach by using the two different scoring systems. Conclusions: This study demonstrats that Tomita with SINS scoring system has higher intra- and interobserver concordance compared with Tokuhashi with SINS scoring system, which can be used as a routine scoring system. Tokuhashi with SINS scoring system is more valuable in decision making as it includes the evaluation of general health situation and neurological status.