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儿童尿动力学测量结果解读中的观察者间及观察者内一致性

Interobserver and intra-observer agreement in interpreting urodynamic measurements in children.

作者信息

Venhola Mika, Reunanen Mikko, Taskinen Seppo, Lahdes-Vasama Tuija, Uhari Matti

机构信息

Department of Pediatrics, Oulu University Hospital, Oulu, Finland.

出版信息

J Urol. 2003 Jun;169(6):2344-6. doi: 10.1097/01.ju.0000059703.28407.a1.

Abstract

PURPOSE

We evaluated the comparability and repeatability of analyses based on urodynamic reports.

MATERIALS AND METHODS

We assessed interobserver and intra-observer agreement when interpreting urodynamic examinations performed in children. Four pediatric urologists analyzed 17 sets of urodynamic data and gave their interpretations of the possible underlying condition of the tested subjects. The consensus among observers was analyzed using the kappa statistic.

RESULTS

Poor agreement was observed on suggested diagnoses based on uroflow curves. Good consensus was noted on maximal flow rates but the interpretations of urethral pressure profile curves and the resulting diagnoses regarding sphincter function differed significantly. It also appeared to be difficult to reach agreement regarding bladder compliance and detrusor activity.

CONCLUSIONS

The consistency of the interpretations of urodynamic studies should be improved before they are accepted as measures for comparing urodynamic diagnoses or effects of treatment between patient series.

摘要

目的

我们评估了基于尿动力学报告的分析的可比性和可重复性。

材料与方法

我们在解读儿童尿动力学检查时评估了观察者间和观察者内的一致性。四位儿科泌尿科医生分析了17组尿动力学数据,并对受试对象可能的潜在病情给出了他们的解读。使用kappa统计量分析观察者之间的共识。

结果

基于尿流曲线的建议诊断一致性较差。最大尿流率方面达成了良好的共识,但尿道压力轮廓曲线的解读以及由此得出的关于括约肌功能的诊断存在显著差异。在膀胱顺应性和逼尿肌活动方面似乎也难以达成一致。

结论

在尿动力学研究的解读一致性得到改善之前,不应将其作为比较患者系列之间尿动力学诊断或治疗效果的指标。

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