Colorado Claudia Lucía, Sánchez Guillermo, Guerrero Martha Inírida, León Clara Inés
Centro Dermatológico Federico Lleras Acosta, E.S.E, Bogotá, D.C, Colombia.
Biomedica. 2011 Jul-Sep;31(3):403-9. doi: 10.1590/S0120-41572011000300012.
After the clinical diagnosis of leprosy, classification methods are necessary to define a treatment and prognosis of patients consistent with bacterial load. Bacteria are detected in skin smear, and bacterial load typically is established by the internationally used Ridley's logarithmic scale, However, in Colombia an alternative semiquantitative scale is used.
The interobserver reproducibility was established for the Ridley and Colombia scales, and the level of correlation-matching was identified between the bacillary indices obtained in order to assess the degree of interchangeability.
Standardization was attained by a reading of the smears by 2 readers with subsequent, blinded evaluation of inter-observer agreement. Each reader quantified the bacterial load of for each sample (n=325) using the Colombian and the Ridley scales. The degree of interobserver agreement was assessed with weighted kappa coefficient. The level of correlation and agreement between the measurements of the bacillary index was established with coefficient of Lin.
The interobserver weighted kappa coefficient was 0.83 for the Colombia scale and 0.85 for the Ridley scale. The Lin coefficient was 0.96 for the correlation-matching of bacillary indexes.
Interobserver agreement obtained for both scales was excellent as the correlation-matching bacillary indices determined with both methods. With the cut-off points yielded a good level of agreement, ensuring interchangeability between the scales defining the high or low bacterial load.
麻风病临床诊断后，需要分类方法来确定与细菌载量相符的患者治疗方案和预后。细菌可在皮肤涂片检测到，细菌载量通常通过国际上使用的里德利对数分级来确定，然而，在哥伦比亚使用的是另一种半定量分级。
确定里德利分级和哥伦比亚分级的观察者间可重复性，并确定所获得的细菌指数之间的相关性匹配水平，以评估互换程度。
通过两名读者对涂片进行阅片实现标准化，随后对观察者间的一致性进行盲法评估。每位读者使用哥伦比亚分级和里德利分级对每个样本（n = 325）的细菌载量进行量化。观察者间一致性程度用加权kappa系数评估。细菌指数测量之间的相关性和一致性水平用林氏系数确定。
哥伦比亚分级的观察者间加权kappa系数为0.83，里德利分级为0.85。细菌指数相关性匹配的林氏系数为0.96。
两种分级获得的观察者间一致性都非常好，因为两种方法确定的细菌指数相关性匹配。截断点产生了良好的一致性水平，确保了定义高或低细菌载量的分级之间的互换性。
