Azuma Hideki, Hori Shiro, Nakanishi Masao, Fujimoto Shinji, Ichikawa Norimasa, Furukawa Toshiaki A
Departments of Psychiatry, Nagoya City University Medical School, Mizuho, Japan.
Psychiatry Clin Neurosci. 2003 Oct;57(5):485-9. doi: 10.1046/j.1440-1819.2003.01152.x.
Several studies have noted modest interrater reliability of clinical electroencephalogram (EEG) interpretations. Moreover, no study to date has investigated a means to improve the observed interrater agreement. The purpose of the present study was to examine (i). the interrater reliability of EEG interpretations among three raters (two psychiatrists and one pediatrician); and (ii). how to improve the reliability by establishing a consensus guideline for EEG interpretation. Three raters, two psychiatrists and a pediatrician, interpreted 100 consecutive EEG recorded at Tajimi General Hospital. After discussing the results of the first trial, the raters established a consensus guideline for EEG interpretation. They then interpreted 50 consecutive EEG recorded at Nagoya City University Hospital following this guideline. Kappa for global judgment of EEG abnormality in three grades (abnormal/borderline/normal) was 0.42 on the first and 0.63 on the second trial. Kappa significantly improved by using the guideline (P = 0.004). It is suggested that discussing and establishing the consensus guideline among the raters offers a feasible method to improve interrater reliability in clinical EEG interpretations.
多项研究指出，临床脑电图（EEG）解读的评分者间信度一般。此外，迄今为止尚无研究探讨提高所观察到的评分者间一致性的方法。本研究的目的是：（i）检验三位评分者（两位精神科医生和一位儿科医生）之间脑电图解读的评分者间信度；（ii）通过建立脑电图解读的共识指南来提高信度。三位评分者，两位精神科医生和一位儿科医生，对多治见综合医院连续记录的100份脑电图进行了解读。在讨论第一次试验的结果后，评分者们建立了脑电图解读的共识指南。然后，他们按照该指南对名古屋市立大学医院连续记录的50份脑电图进行了解读。对于脑电图异常的整体判断分为三个等级（异常/临界/正常），第一次试验的kappa值为0.42，第二次试验为0.63。使用该指南后，kappa值显著提高（P = 0.004）。这表明评分者之间讨论并建立共识指南为提高临床脑电图解读中评分者间的信度提供了一种可行的方法。
