Bousdras Vasileios, Aghabeigi Behnam, Petrie Aviva, Evans Ann W
Department of Oral and Maxillofacial Surgery, Eastman Dental Institute for Oral Health Care Sciences, University College London, United Kingdom.
Int J Oral Maxillofac Implants. 2004 Jul-Aug;19(4):542-8.
This study aimed to (1) compare 2 scales in the assessment of first-stage implant surgery, (2) assess the interrater reliability of these scales, and (3) compare self-assessment with observer assessment.
Twenty-three patients underwent first-stage implant surgery. One assessor, an experienced dental surgeon, assisted and supervised the operator, while the second, a postgraduate trained in assessment, observed the procedure closely. The assessment scales consisted of a checklist and a global rating scale.
A significant correlation was found between the checklist and the global rating scale scores (r = 0.47, P = .002). The British Standards Reproducibility Coefficients were 2.5 (checklist) and 7.4 (global rating scale) for interrater reproducibility and 7.0 (checklist) and 12.6 (global rating scale) for self-assessment versus assessor reproducibility. Finally, analysis of the intraclass correlation coefficients between the assessors (0.74 and 0.64 for the checklist and the global rating scale, respectively) and between the surgeons' and trainers' scores (0.09 for the checklist and 0.18 for the global rating scale) showed a much weaker agreement for the latter.
There was good correlation between scores using the 2 different methods of assessment. The interrater reliability was substantial for both scales. However, training of assessors to ensure higher levels of interrater reliability may be necessary. These results also demonstrated the inability of some surgeons to assess their performance accurately.
Both the checklist and the global rating scales provided useful assessment data, and both were considered of value by the assessors and surgeons in providing feedback. The development of assessment and self-assessment skills in implant surgery is necessary if we are to establish a culture of commitment to lifelong learning.
本研究旨在（1）比较两种评估一期种植手术的量表，（2）评估这些量表的评分者间信度，以及（3）比较自我评估与观察者评估。
23例患者接受了一期种植手术。一名评估者，即一位经验丰富的牙科外科医生，协助并监督手术操作者，而另一名评估者，即一名接受过评估培训的研究生，密切观察手术过程。评估量表包括一份检查表和一份整体评分量表。
检查表与整体评分量表得分之间存在显著相关性（r = 0.47，P = .002）。评分者间再现性的英国标准再现系数，检查表为2.5，整体评分量表为7.4；自我评估与评估者再现性方面，检查表为7.0，整体评分量表为12.6。最后，评估者之间（检查表和整体评分量表分别为0.74和0.64）以及外科医生和培训者得分之间（检查表为0.09，整体评分量表为0.18）的组内相关系数分析显示，后者的一致性要弱得多。
使用两种不同评估方法的得分之间存在良好相关性。两种量表的评分者间信度都很高。然而，可能需要对评估者进行培训，以确保更高水平的评分者间信度。这些结果还表明，一些外科医生无法准确评估自己的表现。
检查表和整体评分量表都提供了有用的评估数据，评估者和外科医生都认为它们在提供反馈方面具有价值。如果我们要建立一种致力于终身学习的文化，那么在种植手术中培养评估和自我评估技能是必要的。
