The professionals with less experience presented an improvement selleck Tipifarnib in the time between the two evaluations, probably due to the interest in and study of the classification, since they knew that they would be assessed for understanding of the topic again. The matter of length of studies can explain the greater agreement of the orthopedic R3 group and orthopedists specialized in feet, since the latter are familiar with the topic and come across it more frequently, and the former due to the studying necessary to acquire the title of specialist. There were some decrease of agreement levels in the second evaluation, in the radiology R2 and R3 groups, orthopedic R2 group and orthopedists. Such an occurrence signifies deterioration in the groups in the subject studied, but may mean evolution of observers inside the group, causing different grades due to study of the classification.
It would be a minor disagreement, which is believed to occur due to knowledge obtained in the interval between evaluations by only part of the observers from each group. Such a bias could be controlled by not informing the study participants of the existence of a second evaluation, which perhaps would not induce study geared towards the subject of many of the observers. Since a classification serves as a prognosis and treatment guideline, it is extremely necessary for there to be agreement among its users. According to the data encountered, we concluded that Hawkins’ classification has achieved goals, facilitating understanding of the case, treatment guidelines, prognosis of the injury and discussions, as it presents satisfactory agreement among its observers.
CONCLUSIONS In the majority of the groups the agreement of Hawkins’ classification can be considered substantial, ranging between 0.6 and 0.8. It is only among the third-year orthopedic residents in the second evaluation that agreement can be considered perfect (0.836). Such a fact can be correlated with the studies undertaken by these residents prior to the examination to achieve the title of orthopedist. However, this contradicts the agreement among orthopedic graduates, whose values were between 0.471 and 0.909, whereas high values are to be expected in both evaluations. The result showed substantial agreement in general in the first and second evaluations, averaging 0.627 and 0.668 respectively.
The data indicate a certain Cilengitide reliability of the classification, but that may vary a great deal according to the evaluator’s experience, confirmed by the greater agreement, in general, pursuant to the years of activity in the area and studies undertaken. Acknowledgments To the direct and indirect participants of this study who made its performance possible. Footnotes All the authors declare that there is no potential conflict of interest referring to this article. Study conducted at the Department of Orthopedics and Traumatology of Universidade Estadual de Campinas, SP.