• Said Sadiqi, MuijsSander P JSPJDepartment of Orthopaedics, University Medical Center Utrecht, HP G05.228, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands., Jeroen J M Renkens, Marcel W Post, Lorin M Benneker, Jens R Chapman, Frank Kandziora, Klaus J Schnake, Emiliano N Vialle, Alexander R Vaccaro, and F Cumhur Oner.
• Department of Orthopaedics, University Medical Center Utrecht, HP G05.228, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands. s.sadiqi-3@umcutrecht.nl.
• Eur Spine J. 2020 Oct 1; 29 (10): 2550-2559.

PurposeTo report on the development of AOSpine CROST (Clinician Reported Outcome Spine Trauma) and results of an initial reliability study.MethodsThe AOSpine CROST was developed using an iterative approach of multiple cycles of development, review, and revision including an expert clinician panel. Subsequently, a reliability study was performed among an expert panel who were provided with 20 spine trauma cases, administered twice with 4-week interval. The results of the developmental process were analyzed using descriptive statistics, the reliability per parameter using Kappa statistics, inter-rater rater agreement using intraclass correlation coefficient (ICC), and internal consistency using Cronbach's α.ResultsThe AOSpine CROST was developed and consisted of 10 parameters, 2 of which are only applicable for surgically treated patents ('Wound healing' and 'Implants'). A dichotomous scoring system ('yes' or 'no' response) was incorporated to express expected problems for the short term and long term. In the reliability study, 16 (84.2%) participated in the first round and 14 (73.7%) in the second. Intra-rater reliability was fair to good for both time points (κ = 0.40-0.80 and κ = 0.31-0.67). Results of inter-rater reliability were lower (κ = 0.18-0.60 and κ = 0.16-0.46). Inter-rater agreement for total scores showed moderate results (ICC = 0.52-0.60), and the internal consistency was acceptable (α = 0.76-0.82).ConclusionsThe AOSpine CROST, an outcome tool for the surgeons, was developed using an iterative process. An initial reliability analysis showed fair to moderate results and acceptable internal consistency. Further clinical validation studies will be performed to further validate the tool.

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