Journal article
Vancouver Foot and Ankle WNS (Wound, Nerve, and Systemic) Classification System for Foot and Ankle Orthopedic Surgery
Foot & ankle international, Vol.39(9), pp.1056-1061
09/2018
DOI: 10.1177/1071100718778022
PMID: 29864377
Abstract
Adverse events require consistent recording to determine the effect of alternate treatments. This study was undertaken to evaluate the Vancouver Foot and Ankle WNS complication scale to capture complications (W: wound, N: nerve, S: systemic) to assist in outcome recording.
Interrater reliability was tested in 2 settings: (1) between 2 blinded clinicians in a live clinical setting and (2) between 8 orthopedic surgeons using case vignettes based on a retrospective analysis of 500 foot and ankle procedures performed at the Toronto Western Hospital, Department of Orthopaedics. The intrarater reliability of the WNS scale was tested in a single rater using the case vignettes. Inter- and intrarater reliability were assessed using the Fleiss and Cohen weighted kappa ( k), respectively and 95% confidence intervals (CIs). There was adequate power over 0.8.
In the live clinical setting, the Cohen weighted k (95% CI) values for the W (0.935 [0.862, 1.01]), N (0.914 [0.752, 1.08]), and S (1 [1, 1]) parameters, indicating a near perfect level of agreement between raters. In the broader community of professional foot and ankle surgeons, the Fleiss k values (95% CI) had moderate agreement for the W (0.712 [0.688, 0.735]), N (0.775 [0.738, 0.811]), and high agreement for S (0.834 [0.802, 0.866]) parameters based on case vignettes. However, the Fleiss k values continued to indicate moderate to strong agreement between raters for all parameters.
The WNS scale provided a standardized method of measuring foot and ankle surgical complications. There was at least moderate-strong interrater agreement for all parameters measured on case vignettes and excellent concordance in the live setting.
Level III, comparative series.
Details
- Title: Subtitle
- Vancouver Foot and Ankle WNS (Wound, Nerve, and Systemic) Classification System for Foot and Ankle Orthopedic Surgery
- Creators
- Andrea Veljkovic - 1 Department of Orthopaedics, University of British Columbia, St. Paul's Hospital, Partner, Footbridge Centre for Integrated Foot and Ankle CareMurray Penner - 1 Department of Orthopaedics, University of British Columbia, St. Paul's Hospital, Partner, Footbridge Centre for Integrated Foot and Ankle CareKevin Wing - 1 Department of Orthopaedics, University of British Columbia, St. Paul's Hospital, Partner, Footbridge Centre for Integrated Foot and Ankle CareKaniza Zahra Abbas - 2 Rosalind Franklin University of Medicine, Chicago Medical School, Chicago, IL, USAPeter Salat - 3 Mayfair Radiology, Department of Radiology, University of Calgary, Calgary, AB, CanadaJohnny Lau - 4 Orthopaedic Foot and Ankle Surgeon, University Health Network, University of Toronto, Toronto Western Hospital, Toronto, ON, CanadaJohn E Femino - 5 Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, USAPhinit Phisitkul - 6 Department of Orthopaedics, University of Iowa Hospitals and Clinics, Iowa City, IA, USAAnnunziato Amendola - 7 James R. Urbaniak, MD, Sports Sciences Institute, Duke University, Durham, NC, USAAlastair Younger - 1 Department of Orthopaedics, University of British Columbia, St. Paul's Hospital, Partner, Footbridge Centre for Integrated Foot and Ankle Care
- Resource Type
- Journal article
- Publication Details
- Foot & ankle international, Vol.39(9), pp.1056-1061
- Publisher
- United States
- DOI
- 10.1177/1071100718778022
- PMID
- 29864377
- ISSN
- 1071-1007
- eISSN
- 1944-7876
- Language
- English
- Date published
- 09/2018
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984040236202771
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