Peris Roig Begoña, Merchante Alfaro Agustín Angel, Tenias Burillo José María, Atienzar Herráez Nieves, Calvo Rigual Fernando, López García M José
Centro de Salud Fuensanta, Valencia.
Rev Esp Salud Publica. 2009 Mar-Apr;83(2):339-43. doi: 10.1590/s1135-57272009000200016.
To estimate the agreement between observers on the detection of goitre by palpation in the school population because it is considered a variability test.
For five months, during 2001/2002, the presence of goitre was studied in across-section sample of 845 school children (for 6 to 14 years old) from 18 school centres in a Health Area in Valentian Community. The exploration was always carried out by the same two observers. The thyroid size was established in 6 degrees. It was considered goitre since 0B inclusive. The agreement was assessed in relation to age, sex, IBM, and the exploration date. The Kappa Index was used as a measure of agreement.
The global prevalence of goitre was 40,4% according to the first observer and 36,8% to the second one. The agreement between observers was high, with a Kappa Index of 0.83 and it was similar in relation to sex, IBM, and the exploration date. It was smaller in the youngest children (six and seven years old) than in the oldest ones (from 12 to 14).
An excellent interobserver agreement in clinic assessment of goitre by palpation in a school children population was achieved. The least concordance was seen in youngest group. It would be advisable to include the study of agreement in the protocol of endemic goitre study.
由于触诊检测甲状腺肿被视为一种变异性测试,故评估观察者之间在学校人群中触诊检测甲状腺肿的一致性。
在2001/2002年的五个月期间,对来自巴伦西亚社区一个卫生区域内18所学校中心的845名6至14岁学童的横断面样本进行甲状腺肿存在情况的研究。触诊检查始终由同两名观察者进行。甲状腺大小分为6度。自0B起包括0B均视为甲状腺肿。根据年龄、性别、体重指数和检查日期评估一致性。kappa指数用作一致性的衡量指标。
第一位观察者检测到的甲状腺肿总体患病率为40.4%,第二位观察者为36.8%。观察者之间的一致性较高,kappa指数为0.83,在性别、体重指数和检查日期方面情况类似。最年幼的儿童(6岁和7岁)中的一致性低于年龄最大的儿童(12至14岁)。
在学童人群中通过触诊对甲状腺肿进行临床评估时,观察者间达成了极佳的一致性。最年幼组的一致性最低。在地方性甲状腺肿研究方案中纳入一致性研究是可取的。