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多中心比较标准 EUS 评分和 Rosemont 分类评分对慢性胰腺炎诊断的观察者间一致性。

Multicenter comparison of the interobserver agreement of standard EUS scoring and Rosemont classification scoring for diagnosis of chronic pancreatitis.

机构信息

Digestive Disease Institute, Cleveland Clinic, Cleveland, OH 44195, USA.

出版信息

Gastrointest Endosc. 2010 Mar;71(3):519-26. doi: 10.1016/j.gie.2009.10.043.

Abstract

BACKGROUND

EUS has less than optimal interobserver agreement for the diagnosis of chronic pancreatitis. The newly developed Rosemont consensus scoring system includes weighted criteria and stricter definitions for individual features.

OBJECTIVE

The primary aim was to compare the interobserver agreement of standard and Rosemont scoring.

SETTING

Multiple tertiary-care institutions.

INTERVENTION

Fifty EUS videos were interpreted by 14 experts. Each expert interpreted the videos on two occasions: First, the videos were read by using standard scoring (9 criteria). Second, after viewing a presentation of the Rosemont classification, the same experts re-read the videos by using Rosemont scoring.

MAIN OUTCOME MEASUREMENTS

Fleiss' kappa (K) statistics are reported with 95% confidence intervals (CI).

RESULTS

The interobserver agreement was "substantial" (K = 0.65 [95% CI, 0.52-0.77]) for Rosemont scoring and "moderate" (K = 0.54 [95% CI, 0.44-0.66]) for standard scoring; however, the difference was not statistically significant (P = 0.12).

LIMITATIONS

The sample size does not allow detection of differences in K of <0.25.

CONCLUSION

Use of the Rosemont classification did not significantly increase interobserver agreement for EUS diagnosis of chronic pancreatitis compared with standard scoring.

摘要

背景

EUS 对慢性胰腺炎的诊断一致性较差。新开发的 Rosemont 共识评分系统包括加权标准和对各个特征的更严格定义。

目的

主要目的是比较标准和 Rosemont 评分的观察者间一致性。

设置

多个三级医疗机构。

干预措施

14 位专家对 50 个 EUS 视频进行了解读。每位专家在两次会议上对视频进行了解读:首先,使用标准评分(9 项标准)解读视频。其次,在观看 Rosemont 分类介绍后,相同的专家使用 Rosemont 评分重新阅读视频。

主要观察指标

Fleiss' kappa(K)统计量以 95%置信区间(CI)报告。

结果

Rosemont 评分的观察者间一致性为“中等”(K = 0.65 [95%CI,0.52-0.77]),标准评分的观察者间一致性为“中等”(K = 0.54 [95%CI,0.44-0.66]);然而,差异无统计学意义(P = 0.12)。

局限性

样本量不足以检测 K 值差异<0.25。

结论

与标准评分相比,使用 Rosemont 分类法并未显著提高 EUS 诊断慢性胰腺炎的观察者间一致性。

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