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- Talk
- 22/09/2021
- UK
Investigating Mirels’ Scoring For Upper Limb Metastasis - Should The Cut-Off For Prophylactic Surgery be Different?
Description
This presentation by Katie Hoban, an ST3 based in Dundee, discusses a study aimed at evaluating the effectiveness of Mirels' score in predicting the risk of pathological fractures in patients with upper limb bony metastases. Throughout the talk, Hoban highlights that metastatic bone disease leads to destructive lesions, particularly affecting the humerus, which is the second most common long bone involved after the femur.
She details that the study focuses on the relevance and accuracy of maintaining the original Mirels' scoring threshold, which was initially optimized for the femur. The findings suggest that the conventional cut-off score of nine does not accurately predict fractures, as evidenced by a significantly lower fracture rate (11%) associated with this scoring alongside a higher rate (65%) for scores of eight or lower. Furthermore, Hoban discusses the variability observed both within and among the raters assessing the radiographs.
The study concludes that Mirels' score demonstrates fair reproducibility but highlights the poor sensitivity and specificity in predicting upper limb fractures. Consequently, Hoban recommends considering a lower threshold for prophylactic surgery in upper limb bony metastases to enhance patient safety and treatment efficacy. Overall, this presentation sets the stage for further discussions on refining predictive measures in orthopedic oncology.