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a panel consisting of observers from one specialty can result in very high levels of agreement.9 Therefore, the optimal reviewing panel for such a study remains to be determined, but it seems observers from a surgical specialty generally have the highest level of agreement.
In conclusion, this study provides an insight into the ability of the SINS to assess spinal instability in patients undergoing external beam radiation therapy for spinal bone metastases. Based on these results, the clinical applicability of the SINS as a tool to assess spinal instability seems limited.
SINS
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VII
