Reliability of the Spinal Deformity Study Group Classification of Lumbosacral Spondylolisthesis
Bibliographic record
Abstract
STUDY DESIGN: Reliability study of the computer-assisted SDSG (Spinal Deformity Study Group) classification of lumbosacral spondylolisthesis. OBJECTIVE: To assess the intra- and interobserver reliability of the computer-assisted SDSG classification of lumbosacral spondylolisthesis. SUMMARY OF BACKGROUND DATA: The SDSG has proposed a new classification of lumbosacral spondylolisthesis based on slip grade, pelvic incidence (PI), and sacro-pelvic and spinal balance. Three types of low-grade spondylolisthesis are described: low PI (type 1), normal PI (type 2), and high PI (type 3). High-grade spondylolisthesis are defined as type 4 (balanced sacro-pelvis), type 5 (retroverted sacro-pelvis with balanced spine), and type 6 (retroverted sacro-pelvis with unbalanced spine). METHODS: Full-length standing lateral radiographs of the spine of 40 subjects with lumbosacral spondylolisthesis were reviewed twice by 7 observers. Custom software was used by the observers to identify 7 anatomical landmarks on each radiograph to determine the SDSG type for all subjects. Percentage of agreement and κ coefficients were used to determine the intra- and interobserver reliability. RESULTS: All 6 types of spondylolisthesis described in the computer-assisted SDSG classification were identified. Overall intra- and interobserver agreements were 80% (κ: 0.74) and 71% (κ: 0.65), respectively. The intra- and interobserver agreements associated with computerized determination of slip grade were 92% (κ: 0.83) and 88% (κ: 0.78), respectively. As for computerized determination of sacro-pelvic and spinal balance, intra- and interobserver agreements were 86% (κ: 0.76) and 75% (κ: 0.63) for low-grade slips, whereas they were 88% (κ: 0.80) and 83% (κ: 0.75) for high-grade slips. CONCLUSION: Substantial intra- and interobserver reliability was found for the computer-assisted SDSG classification, and all 6 types of lumbosacral spondylolisthesis were identified. Refinement of the computer-assisted classification technique is, however, needed to further increase the reliability of the SDSG classification and facilitate its clinical use.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".