Tiel-van Buul M M, van Beek E J, Broekhuizen A H, Nooitgedacht E A, Davids P H, Bakker A J
Department of Nuclear Medicine, Academic Medical Centre, University of Amsterdam, The Netherlands.
Injury. 1992;23(2):77-9. doi: 10.1016/0020-1383(92)90035-q.
To evaluate the reproducibility of the interpretation of radiographs for the diagnosis of scaphoid fractures, 134 radiographs (60 consecutive patients) were blindly observed by a resident radiologist, consultant radiologist, resident trauma surgeon and consultant trauma surgeon. The results of radiographs were analysed using kappa (kappa) statistics and stratified according to the results of the corresponding bone scan. In 23 patients the bone scan was positive for fracture of the scaphoid. Irrespective of training and experience, the kappa of the comparison of the scores of the radiographs between any two observers did not exceed 40 per cent. After stratification of the outcome of the bone scan, the kappa did not increase significantly. A panel of three experienced observers gave their opinion of all radiographs. The results were compared with the bone scan results. We conclude that radiographs in suspected scaphoid fracture cannot be used as a reliable diagnostic approach because of the low inter-observer agreement in the interpretation, irrespective of the experience and training of the observer.
为评估X线片用于诊断舟状骨骨折的解读可重复性，一名住院放射科医师、一名放射科会诊医师、一名住院创伤外科医师和一名创伤外科会诊医师对134张X线片（60例连续患者）进行了盲法观察。使用kappa统计分析X线片结果，并根据相应骨扫描结果进行分层。23例患者的骨扫描显示舟状骨骨折阳性。无论培训和经验如何，任意两名观察者之间X线片评分比较的kappa值均未超过40%。根据骨扫描结果分层后，kappa值也未显著增加。由三名经验丰富的观察者组成的小组对所有X线片给出了意见。将结果与骨扫描结果进行比较。我们得出结论，由于观察者之间在解读上的一致性较低，无论观察者的经验和培训如何，疑似舟状骨骨折的X线片都不能用作可靠的诊断方法。
