Bouros D, Maltezakis G, Tzanakis N, Tzortzaki E, Siafakas N
Department of Thoracic Medicine, Medical School, University of Crete, Heraklion, Greece.
Respir Med. 1992 May;86(3):219-23. doi: 10.1016/s0954-6111(06)80059-4.
We have shown previously that experienced readers can use the palpation or pen method for reading the Mantoux tuberculin skin test with accuracy. In order to investigate if the inexperienced reader can use both methods with the same degree of accuracy, we performed Mantoux tests in 539 healthy subjects, aged 20-57 years (mean 33 years), using the PPD-RT 23 in dose 2 I.U. (1/5000). In random order and a double-blind fashion, an experienced and an inexperienced reader measured the induration after 48 h by the palpation method initially and then by the pen method, without knowing the identity of the subject. Results of the study did not show any significant difference in any range of measurements by the two readers, using either the pen or palpation method (P greater than 0.1). A highly statistically significant linear relationship was found between the measurements by the pen method used by experienced and inexperienced readers (r = 0.823, P less than 0.0001) and between the palpation measurements by the two readers (r = 0.939, P less than 0.0001). We conclude that the effects of an inexperienced examiner in the measurement of of tuberculin skin induration are minimal. Inexperienced readers can use the pen method as accurately as the traditional palpation method.
我们之前已经表明，经验丰富的阅片者可以准确地使用触诊法或笔测法来解读结核菌素皮肤试验（曼氏试验）。为了研究缺乏经验的阅片者是否能以同样的准确度使用这两种方法，我们对539名年龄在20至57岁（平均33岁）的健康受试者进行了曼氏试验，使用剂量为2国际单位（1/5000）的PPD-RT 23。以随机顺序和双盲方式，一名经验丰富的阅片者和一名缺乏经验的阅片者在48小时后，先通过触诊法测量硬结，然后通过笔测法测量，且不知道受试者的身份。研究结果显示，两位阅片者使用笔测法或触诊法在任何测量范围内均无显著差异（P大于0.1）。经验丰富的阅片者和缺乏经验的阅片者使用笔测法的测量结果之间（r = 0.823，P小于0.0001）以及两位阅片者触诊测量结果之间（r = 0.939，P小于0.0001）均发现具有高度统计学意义的线性关系。我们得出结论，缺乏经验的检查者在测量结核菌素皮肤硬结时影响极小。缺乏经验的阅片者使用笔测法的准确度与传统触诊法相同。
