Den Boon S, Bateman E D, Enarson D A, Borgdorff M W, Verver S, Lombard C J, Irusen E, Beyers N, White N W
Department of Paediatrics and Child Health, Faculty of Health Sciences, Desmond Tutu TB Centre, Stellenbosch University, Cape Town, South Africa.
Int J Tuberc Lung Dis. 2005 Oct;9(10):1088-96.
The development and evaluation of a new chest radiograph reading and recording system (CRRS) for community surveys of tuberculosis (TB) and lung disease.
An experienced pulmonologist read 2608 chest X-rays (CXRs) performed as part of a TB prevalence survey using the newly developed CRRS. The kappa (kappa) for inter-reader agreement was calculated after a second reader reported on a stratified random sample of 810 (31%) of the 2608 CXRs. The kappa for intra-reader agreement was calculated from the repeated reporting of a stratified random sample of 104 CXRs.
The kappa agreement between the two readers was 0.69 (95%CI 0.64-0.74) for abnormalities consistent with TB and 0.47 (95%CI 0.42-0.53) for any abnormalities. The kappa for intra-reader agreement was 0.90 (95%CI 0.81-0.99) for abnormalities consistent with TB and 0.85 (95%CI 0.74-0.95) for any abnormalities.
This standardised method for CXR reading and recording provides satisfactory inter- and intra-reader agreement, making it suitable for surveys of TB and other forms of lung disease in the community. Its use will permit comparisons of results obtained in different surveys.
开发并评估一种用于结核病（TB）和肺部疾病社区调查的新型胸部X线阅片及记录系统（CRRS）。
一名经验丰富的肺科医生使用新开发的CRRS对作为结核病患病率调查一部分所拍摄的2608张胸部X线片（CXR）进行阅片。在另一名阅片者对2608张CXR中的810张（31%）分层随机样本进行报告后，计算阅片者间一致性的kappa值。阅片者内一致性的kappa值由对104张CXR分层随机样本的重复报告计算得出。
两位阅片者之间，与TB相符的异常情况的kappa一致性为0.69（95%CI 0.64 - 0.74），任何异常情况的kappa一致性为0.47（95%CI 0.42 - 0.53）。阅片者内一致性方面，与TB相符的异常情况的kappa值为0.90（95%CI 0.81 - 0.99），任何异常情况的kappa值为0.85（95%CI 0.74 - 0.95）。
这种用于CXR阅片和记录的标准化方法在阅片者间和阅片者内均具有令人满意的一致性，使其适用于社区中的TB及其他形式肺部疾病的调查。使用该方法将能够比较不同调查中获得的结果。
