Williams J W, Roberts L, Distell B, Simel D L
Center for Health Services Research in Primary Care, Durham VAMC, North Carolina.
J Gen Intern Med. 1992 Sep-Oct;7(5):481-5. doi: 10.1007/BF02599447.
To determine whether a single Waters view (occipito-mental) radiograph could be substituted for a four-view sinus series to diagnose sinusitis, and to determine the inter- and intraobserver variabilities for sinus radiography.
Radiographs were interpreted by radiologists blinded to the clinical history, and results were recorded on a standardized form.
Veterans Affairs Medical Center.
Staff attending radiologists, an attending radiologist with special training in skull radiology, and a senior radiology resident.
The agreement between the Waters view and the four-view sinus series was moderate to substantial (simple agreement = 75-84%, kappa = 0.5-0.68). However, agreement varied by sinus and, after correction for chance agreement, was substantial only for the maxillary sinuses (kappa = 0.72-0.87). Intraobserver agreement (kappa = 0.72-0.84) was superior to interobserver agreement (kappa = 0.49-0.59) for the four-view sinus series.
Substituting a single Waters view for a four-view sinus series may be an acceptable strategy for diagnosing maxillary sinusitis.
确定单张华氏位（枕颏位）X线片是否可替代鼻窦四视图系列片来诊断鼻窦炎，并确定鼻窦X线摄影的观察者间和观察者内变异性。
由对临床病史不知情的放射科医生解读X线片，并将结果记录在标准化表格上。
退伍军人事务医疗中心。
放射科主治医生、一名在颅骨放射学方面接受过特殊培训的主治放射科医生以及一名放射科高级住院医师。
华氏位片与鼻窦四视图系列片之间的一致性为中度到高度（简单一致性=75 - 84%，kappa值=0.5 - 0.68）。然而，一致性因鼻窦不同而有所差异，校正机遇一致性后，仅在上颌窦方面具有高度一致性（kappa值=0.72 - 0.87）。对于鼻窦四视图系列片，观察者内一致性（kappa值=0.72 - 0.84）优于观察者间一致性（kappa值=0.49 - 0.59）。
用单张华氏位片替代鼻窦四视图系列片可能是诊断上颌窦炎的一种可接受策略。
