Opinions

Letter to the Editor: “Interobserver reliability of the Tile classification system for pelvic fractures among radiologists and surgeons”

by Rafael Gómez, Manuela Gallo, Sergio Valencia (sevava92@gmail.com)

Interobserver reliability of the Tile classification system for pelvic fractures among radiologists and surgeons

Dear Editor,

We were pleased to read the article by Zingg et al, entitled “Interobserver reliability of the Tile classification system for pelvic fractures among radiologists and surgeons” [1]. The author’s purpose was to define the inter-observer reliability between radiologists and surgeons with different years of expertise and they found that interobserver reliability (IOR) for this classification was only fair to moderate and it is better among radiologists with a higher level of experience.

The main concern after reading this article was to establish the real utility of the Tile classification due to it is a classification with a total of 26 second-order subcategories making it hard to apply and learn, taking that into account knowing that there is a fair IOR, and the scale does not have a prognostic correlation. We would like to ask the authors if they will be still using the Tile classification for describing pelvic ring fractures?

We believe that a diagnostic classification should have 4 minimum requirements: 1. Easy to learn and apply; 2. Few categories; 3. Moderate interobserver agreement; 4. Internal and external validation. Also, a classification model should be useful for all the participants in the patient attention, from the radiologist to the treating physician.

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