Detre K M, Wright E, Murphy M L, Takaro T
Circulation. 1975 Dec;52(6):979-86. doi: 10.1161/01.cir.52.6.979.
The reliability of interpretation of coronary arteriography as a diagnostic tool was investigated in a sub-study of the VA Cooperative Study of Surgical Treatment for Coronary Arterial Occlusive Disease. Twenty-two physicians with varying levels of experience read 13 cine angiograms -- blind -- on two different occasions. Analysis of inter- and intraobserver variability showed that angiographic items about which observers were most inconsistent from one reading to the other had the largest interobserver disagreement as well. They were the distal portions of the left anterior descending and left circumflex arteries. Among the items on which there was most consistent agreement -- namely, the right main coronary artery and presence of ventricular aneurysm -- there was most often agreement between observers as well. When individual readers were evaluated, some observers were far more consistent in their own readings of all the angiographic items than others. This intraobserver agreement in turn correlated fairly well with how often they agreed with the other observers and with how much experience they reported having in reading coronary cineangiograms.
在退伍军人事务部冠状动脉闭塞性疾病外科治疗合作研究的一项子研究中，对冠状动脉造影作为一种诊断工具的解读可靠性进行了调查。22名经验水平各异的医生在两个不同时间对13份电影血管造影进行了盲法阅读。观察者间和观察者内变异性分析表明，观察者在不同阅读之间最不一致的血管造影项目，其观察者间分歧也最大。它们是左前降支和左旋支动脉的远端部分。在观察者之间最一致同意的项目中，即右冠状动脉主干和室壁瘤的存在，观察者之间也最常达成一致。当对个体读者进行评估时，一些观察者在对所有血管造影项目的自身阅读中比其他观察者更加一致。这种观察者内一致性反过来与他们与其他观察者达成一致的频率以及他们报告的阅读冠状动脉电影血管造影的经验程度相当相关。
