Many different radiographic grading systems for @entity1797 are described in literature. However, only a few of them are tested for interobserver agreement and none for validity. Furthermore, most of them are based on a subjective terminology. The aim of this study, therefore, is to combine these systems to a new one in which all subjective terms are replaced by more objective ones and to test this new system for validity and interobserver agreement. Since lumbar and cervical discs need to be graded differently, this study was divided into the present Part I for the lumbar and a Part II for the cervical spine. The new radiographic grading system covers the three variables "Height Loss", "Osteophyte Formation" and " @entity7622 ". On lateral and postero-anterior radiographs, each of these three variables first has to be graded individually. Then, the "Overall Degree of Degeneration" is assigned on a four-point scale from 0 (no @entity528 ) to 3 (severe @entity528 ). For validation, the radiographic degrees of @entity1797 were compared to the respective macroscopic ones, which were defined as "real" degrees of @entity528 . The agreement between observers with different levels of experience was determined using the radiographs of 84 lumbar discs. Agreement was quantified using quadratic weighted Kappa coefficients (Kappa) with 95% confidence limits (95% CL). The validation of the new radiographic grading system revealed a substantial agreement between the radiographic and the "real" macroscopic overall degree of @entity528 (Kappa=0.714, 95% CL: 0.587-0.841). The radiographic grades, however, tended to be slightly lower than the "real" ones. The interobserver agreement was substantial for all the three variables and for the overall degree of @entity528 (Kappa=0.787, 95% CL: 0.702-0.872). However, the inexperienced observer tended to assign slightly lower degrees of @entity528 than the experienced one. In conclusion, we believe that the new radiographic grading system is an almost objective, valid and reliable tool to quantify the degree of @entity528 of individual lumbar intervertebral discs. However, the user should always remember that the "real" degree of @entity528 tends to be underestimated and that slight differences between the ratings of observers with different levels of experience have to be expected.

Validity and interobserver agreement of a new radiographic grading system for XXXX : Part I. Lumbar spine.

@entity1797 :: ('MESH:D055959', 'Disease') :: ['degeneration of 44 lumbar discs', 'disc degeneration'] @entity7622 :: ('MESH:C537346', 'Disease') :: ['Diffuse Sclerosis'] @entity528 :: ('MESH:D009410', 'Disease') :: ['degeneration']
@entity1797 :: (MESH:D055959,Disease) :: ['intervertebral disc degeneration']
