PMID: 9160937May 1, 1997Paper

Severin classification system for evaluation of the results of operative treatment of congenital dislocation of the hip. A study of intraobserver and interobserver reliability

The Journal of Bone and Joint Surgery. American Volume
W T WardR D Fitch

Abstract

The Severin classification system frequently is used to evaluate the radiographic results of operations performed for the treatment of congenital dislocation of the hip. However, the reliability of this classification scheme has not been established, to our knowledge. Ideally, a classification system should be validated before it is used to promote therapeutic guidelines or to compare results of treatment; the purpose of the present study was to establish the intraobserver and interobserver reliability of the Severin classification system. Four blinded raters and the operating surgeon independently used the Severin system to evaluate the most recent radiographs of thirty-seven children (fifty-six hips) who had been managed, an average of nine years previously, with a medial open reduction for congenital dislocation of the hip. Three of the raters evaluated the same radiographs again under similar testing circumstances eight weeks later. Ten paired interobserver and three intraobserver comparisons then were analyzed with use of the Cohen kappa coefficient (kappa). The average kappa coefficient for the six pairwise comparisons between the four blinded raters was 0.15 (range, -0.05 to 0.42) when all Severin classes were analyzed i...Continue Reading

Citations

Sep 15, 2000·Clinical Orthopaedics and Related Research·E GotohM Ando
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