Lorentzen H F, Holstein P, Gottrup F
Videncenter for sårheling S, H:S Bispebjerg Hospital.
Ugeskr Laeger. 1999 Nov 1;161(44):6045-8.
Communicating wound descriptions between disciplines for treatment and wound care necessitates a simple and unequivocal classification system. The Red-Yellow-Black (RYB) system has been suggested to comply with these demands. The reliability of the RYB-system has, however only been investigated in small studies. The aim of this study was to determine interobserver homogeneity (group Kappa a.m. Schouten) of the RYB-system and further to examine whether interobserver homogeneity was dependent on educational level. One-hundred-and-twenty photo-slides of non-healing ulcers of various etiologies were shown to 21 observers who recorded their assessments in an entry form without discussing their assessments with the other observers. Eighty-nine percent of the possible assessments were completed. Observed agreement for all observers = 0.65; Kappa = 0.47. Kappa-coefficient in subgroup of nurses = 0.49, subgroup of physicians with less than three years of experience with wound treatment = 0.46 and for physicians with more than 10 years of experience with wound healing = 0.48. In conclusion, we demonstrated moderate interobserver agreement for using the RYB-characteristics. The RYB-system is useful for communication about wound care and treatment. However, continuous education and consensus meetings are advisable to increase agreement.
在不同学科之间交流伤口描述以进行治疗和伤口护理，需要一个简单明确的分类系统。有人建议采用红-黄-黑（RYB）系统来满足这些要求。然而，RYB系统的可靠性仅在小型研究中得到过调查。本研究的目的是确定RYB系统的观察者间同质性（采用Schouten等人的组内Kappa值），并进一步研究观察者间同质性是否取决于教育水平。向21名观察者展示了120张不同病因的不愈合溃疡的照片幻灯片，他们在一份登记表中记录自己的评估结果，且未与其他观察者讨论评估情况。完成了89%的可能评估。所有观察者的观察一致性为0.65；Kappa值为0.47。护士亚组的Kappa系数为0.49，伤口治疗经验少于三年的医生亚组为0.46，伤口愈合经验超过十年的医生亚组为0.48。总之，我们证明了在使用RYB特征方面观察者间存在中等程度的一致性。RYB系统有助于伤口护理和治疗方面的交流。然而，建议持续开展教育活动并召开共识会议以提高一致性。
