van Dillen Jeroen, Diesch Marijn, Schutte Joke, Zwart Joost, Wolterbeek Ron, van Roosmalen Jos
Department of Obstetrics, Leiden University Medical Centre, Leiden, The Netherlands.
Int J Gynaecol Obstet. 2009 Oct;107(1):16-8. doi: 10.1016/j.ijgo.2009.05.001. Epub 2009 May 27.
To evaluate the agreement between the traditional binary system and a new system for classifying urgency of cesarean delivery among obstetricians in The Netherlands and Belgium.
A total of 212 obstetricians were requested to grade a list of 18 obstetric scenarios using 3 classification systems: traditional binary classification; a new classification using 4 grades of urgency without additional interpretation; and the new classification with additional interpretation. Agreement was assessed by weighted kappa.
Seventy-nine obstetricians responded (The Netherlands 62.2%, Belgium 9.9%). There was substantial agreement among them for all 3 classification systems (kappa=0.71, traditional classification; kappa=0.70, new classification; kappa=0.67, new classification with additional interpretation).
The traditional binary system and the new classification of cesarean delivery based on 4 grades of urgency, with and without additional interpretation, have similar but relatively low interobserver agreement. We suggest that the new classification should be used, but future studies are necessary to evaluate the effect of this implementation.
评估荷兰和比利时产科医生中传统二元分类系统与一种新的剖宫产分娩紧急程度分类系统之间的一致性。
共邀请212名产科医生使用3种分类系统对18种产科情况列表进行分级：传统二元分类；一种新的使用4种紧急程度等级且无额外解释的分类；以及带有额外解释的新分类。通过加权kappa评估一致性。
79名产科医生做出回应（荷兰62.2%，比利时9.9%）。他们对所有3种分类系统都有高度一致性（kappa = 0.71，传统分类；kappa = 0.70，新分类；kappa = 0.67，带有额外解释的新分类）。
传统二元系统以及基于4种紧急程度等级的剖宫产分娩新分类，无论有无额外解释，观察者间一致性相似但相对较低。我们建议使用新分类，但未来有必要进行研究以评估这种实施的效果。
