Galli M, De Santis V, Tafuro L
Orthopaedic Department, Catholic University, Rome, Italy.
Osteoarthritis Cartilage. 2003 Aug;11(8):580-4. doi: 10.1016/s1063-4584(03)00095-5.
The aim of the study was to assess the inter-observer reliability and intra-observer reproducibility of the Ahlbäck radiographic classification for knee osteoarthritis (OA).
Ninety-six knee radiographs of patients with clinical signs of arthritis were evaluated and classified into five grades of Ahlbäck classification by three observers with different experience. The evaluation was repeated after 1 month. The inter- and intra-rater agreements were assessed by statistical analysis (k and k(w)coefficients).
The inter-observer agreement was statistically significant, but with low or medium values of the coefficients. The intra-rater agreement was less significant than the inter-rater. Inter- and intra-rater agreement coefficients decreased when the cases of stage V arthritis were excluded from the analysis. The evaluations were influenced by the age and working experiences of each observer.
The authors stress that the Ahlbäck classification, as routinely applied, should not be used in orthopaedic surgery without the support of clinical and/or arthroscopic examinations, because of its poor reliability.
本研究旨在评估用于膝关节骨关节炎（OA）的阿尔贝克（Ahlbäck）X线分类法在不同观察者间的可靠性以及同一观察者内部的可重复性。
对96例有临床关节炎体征患者的膝关节X线片进行评估，由三名经验不同的观察者将其分为阿尔贝克分类法的五个等级。1个月后重复评估。通过统计分析（k和k(w)系数）评估观察者间和观察者内的一致性。
观察者间一致性具有统计学意义，但系数值较低或中等。观察者内一致性不如观察者间一致性显著。当将V期关节炎病例排除在分析之外时，观察者间和观察者内一致性系数降低。评估受每位观察者的年龄和工作经验影响。
作者强调，由于可靠性较差，常规应用的阿尔贝克分类法在没有临床和/或关节镜检查支持的情况下，不应在骨科手术中使用。
