In an effort to improve treatment for skeletal metastatic cancer – the most deadly form of the cancer – the Spanish Back Pain Research Network, Kovacs Foundation, conducted a study to see correlation between the Tomita and modified Bauer scores when determining the prognosis and surgical strategy. The goal of the study was to establish a standardized method of communicating the severity of metastatic spine disease through medical oncologists, radiologists, radiation oncologists, orthopedic surgeons, and neurosurgeons.
Eighty-three doctors with multiple levels of post-residency practice, specialties, and hospital complexity participated in the study and the first 90 patients that met the inclusion criteria and did not meet any of the exclusion criteria were accepted as subject participants. Intraobserver and interobserver variability were taken into account amongst the clinicians. Patient information was limited to two (2) MRIs and a clinical vignette of basic patient history and treatment.
Both intra- and inter-observer agreements were almost entirely “almost perfect” and “substantial.” This high agreement correlation could improve the efficiency and efficacy of treatment for patients with metastatic spine diseases. Previous studies have examined the benefits one scoring system over the other, but this is one of the first studies to utilize both scores for a better inter-disciplinary communication system. Future studies may have a more specific group of doctors, particular cancer subtypes and/or location of metastases, or hospital categories to further determine the best scenarios for interobserver communication.