Unit for Rheumatology, Ludwig-Maximilians-University, Munich, Germany.
J Rheumatol. 2010 Apr;37(4):860-4. doi: 10.3899/jrheum.090195. Epub 2010 Feb 15.
To reduce the amount of variability among assessors, we conducted joint examination standardization seminars in conjunction with multicenter clinical trials for patients with rheumatoid arthritis (RA). The examination techniques used were based on the recommendations of the European League Against Rheumatism (EULAR).
To evaluate the effect of standardization, participants at the seminars examined a given patient with RA before and after they were made familiar with the EULAR examination technique. The number of tender and swollen joints as well as the variance among the examiners before and after the training were compared. Joints were rated positive or negative for tenderness and swelling without grading.
Overall, 553 individuals from a variety of countries in Europe, North America, Asia, and Australia participated. Examiners included different kinds of health professionals, mainly physicians and nurses. We found a substantial variance among examiners before the training in the standardized method. This variance could be significantly reduced by the training. We also found that the number of joints considered active was markedly reduced after the training.
Standardized joint examination training significantly reduces variability among different assessors.
为了减少评估者之间的变异性，我们针对类风湿关节炎（RA）患者的多中心临床试验开展了联合检查标准化研讨会。所使用的检查技术基于欧洲抗风湿病联盟（EULAR）的建议。
为了评估标准化的效果，研讨会的参与者在熟悉 EULAR 检查技术前后对特定的 RA 患者进行了检查。比较了培训前后压痛和肿胀关节的数量以及评估者之间的差异。关节的压痛和肿胀情况不分级，只分为阳性或阴性。
总体而言，来自欧洲、北美、亚洲和澳大利亚的多个国家的 553 人参加了研讨会。评估者包括不同类型的卫生专业人员，主要是医生和护士。我们发现，在培训前，使用标准化方法时评估者之间存在很大的差异。这种差异可以通过培训显著降低。我们还发现，培训后考虑为活动期的关节数量明显减少。
标准化关节检查培训显著降低了不同评估者之间的变异性。
