Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.
Equine Vet J. 2011 Jul;43(4):399-403. doi: 10.1111/j.2042-3306.2010.00300.x. Epub 2010 Sep 29.
REASON FOR PERFORMING STUDY: Different examiners or the same examiner were observed at different times producing slightly different results when obtaining cervical-vertebral ratios. If the difference is substantial, then measurement variability would have an important impact of radiographic interpretation. OBJECTIVE: To quantify agreement and repeatability of these measurements. METHODS: An observer agreement study was performed using 75 horses. Measurements were made at C3-4 and C6-7 by a board-certified radiologist and an imaging resident. Intra- and interobserver agreement was quantified using Bland-Altman plots. Repeatability was assessed as the percentage of differences between duplicate measurements by the radiologist that were within ± 2 s.d. of the differences. RESULTS: At C3-4, the limits of agreement for the intra-vertebral ratio were between -5 and 4% for the intra- and -5 and 6% for interobserver comparison. For the intervertebral ratio, they were between -9 and 8% for the intra- and -10 and 10% for interobserver comparison. At C6-7, the limits of agreement for the intra-vertebral ratio were between -6 and 5% for the intra- and -6 and 8% for interobserver comparison. For the intervertebral ratio, they were between -7 and 7% for the intra- and -6 and 13% for interobserver comparison. At C3-4, all measurements were 95% repeatable (differences typically ≤ 4% and always ≤ 8%) for the intra-vertebral ratio and 96% repeatable (differences typically ≤ 8% and always ≤ 11%) for the intervertebral ratio. At C6-7, all measurements were 98% repeatable (differences typically ≤ 6% and always ≤ 7%) for the intravertebral ratio and 92% repeatable (differences typically ≤ 6% and always ≤ 10%) for the intervertebral ratio. CONCLUSIONS: Cervical-vertebral ratios typically varied by 5-10% within and between examiners. POTENTIAL RELEVANCE: When using cervical-vertebral ratios in practice, the impact of measurement agreement should be factored into the interpretation of the test result because measurement variability may lead to misdiagnosis and limit the clinical usefulness of these tests.
研究原因：当获取颈椎比值时，不同的检查者或同一检查者在不同时间会产生略有不同的结果。如果差异很大，则测量变异性将对影像学解释产生重要影响。
目的：量化这些测量的一致性和可重复性。
方法：使用 75 匹马进行了观察者一致性研究。由一名 board-certified radiologist 和一名影像科住院医师在 C3-4 和 C6-7 处进行测量。使用 Bland-Altman 图量化了内-间和间-间观察者的一致性。通过放射科医生对重复测量的差异进行评估，重复性为重复测量的差异在差异的±2 s.d.内的差异百分比。
结果：在 C3-4 处，内椎体比的一致性界限为内观察者比较的-5%至 4%和-5%至 6%，而间观察者比较的为-9%至 8%和-10%至 10%。在 C6-7 处，内椎体比的一致性界限为内观察者比较的-6%至 5%和-6%至 8%，而间观察者比较的为-7%至 7%和-6%至 13%。在 C3-4 处，对于内椎体比，所有测量结果均具有 95%的可重复性（差异通常≤4%，且始终≤8%），对于间椎体比，所有测量结果均具有 96%的可重复性（差异通常≤8%，且始终≤11%）。在 C6-7 处，对于内椎体比，所有测量结果均具有 98%的可重复性（差异通常≤6%，且始终≤7%），对于间椎体比，所有测量结果均具有 92%的可重复性（差异通常≤6%，且始终≤10%）。
结论：颈椎比值在检查者内部和之间通常变化 5-10%。
潜在相关性：在实践中使用颈椎比值时，应将测量一致性的影响纳入测试结果的解释中，因为测量变异性可能导致误诊，并限制这些测试的临床实用性。
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