Gunasti Suhan, Mulayim Mehmet Kamil, Fettahloglu Bilge, Yucel Aydn, Burgut Refik, Sertdemir Yasar, Aksungur Varol Lutfu
Department of Dermatology, Cukurova University, Adana/Turkey.
Melanoma Res. 2008 Aug;18(4):284-8. doi: 10.1097/CMR.0b013e328307c25a.
The clinical ABCD criteria are still recommended to both physicians and laymen when checking moles. The aim of this study was to determine the level of interrater reliability and therefore objectivity in rating for one of these criteria, namely border irregularity. Five professors, five residents, five nurses, and 10 students rated a set of 54 clinical images of pigmented skin lesions for border irregularity. After a descriptive presentation, rating was again carried out on another set of 54 images. In all groups, the agreement was moderate or substantial before the presentation and increased after the presentation. An almost perfect agreement was achieved by the professors after the presentation. Although both experience and receiving information could increase the level of interrater reliability, the disagreement was usually sufficient to suggest subjectivity in rating for border irregularity.
在检查痣时,临床ABCD标准仍被推荐给医生和普通民众。本研究的目的是确定评估者间信度水平,从而确定这些标准之一(即边界不规则)评估的客观性。五名教授、五名住院医师、五名护士和十名学生对一组54张色素沉着性皮肤病变的临床图像进行边界不规则评估。在进行描述性展示后,又对另一组54张图像进行评估。在所有组中,展示前的一致性为中等或较高,展示后有所增加。展示后教授们达成了几乎完美的一致性。虽然经验和获取信息都可以提高评估者间信度水平,但分歧通常足以表明在边界不规则评估中存在主观性。