Vlad Violeta, Berghea Florin, Iagnocco Annamaria, Micu Mihaela, Damjanov Nemanja, Skakic Vlado, Prodanovic Slavica, Radunovic Goran, Szkudlarek Marcin, Nestorova Rodina, Petranova Tzvetanka, Kakavouli Jasna, Porta Francesco, Perricone Carlo, Ciechomska Anna, Moller Ingrid, Varzaru Luminita, Peric Porin, Dejaco Christian, Bojinca Mihai, Fodor Daniela, Milicescu Mihaela, Naredo Esperanza
Clinical Hospital Sf. Maria, Bucharest, Romania, Email:
UMF "Carol Davila" Bucharest, Romania.
Med Ultrason. 2014 Mar;16(1):32-6. doi: 10.11152/mu.2014.2066.161.vv1fb2.
To evaluate the inter- and intraobserver agreement of a group of European rheumatologist ultrasonographers in grading musculoskeletal ultrasound videoclips posted on the Internet by using a non-sophisticated electronic environment.
Forty short movie clips (less than 30 secs) were made available over the Internet to all participants. Normal and pathological RA hand joints and tendons were included in the movie clips. In the first phase 30 investigators from European countries were invited to evaluate the clips and to interpret/grade them. No instruction session was held prior to the initiation of the study. For synovitis the requested scoring system included 0 to3 grades and for tenosynovitis a binary variable 0/1; separate evaluations were performed for gray scale (GS) and Power Doppler (PD) examinations. In the second phase the responders were asked to grade the same clips in a different order without having access to their first grading scale. Light's k and Cohen's k were used to analyse inter- and intraobserver reliability.
Twenty two European rheumatologists agreed to finalise both study phases. Mean Cohen's κ for intraobserver reliability was 0.614/0.689 for tenosynovitis GS/PD and 0.523/0.621 for synovitis GS/PD. Light's k for interobserver reliability was 0.503 for tenosynovitis evaluation and 0.455 for global (synovitis and tenosynovitis) evaluation. Mean global overall agreement was 84.95% (90.2% for global synovitis).
An over-the-net US evaluation and grading has shown moderate to good reliability. The results could be improved if a training session is added at the beginning of the study.
利用一个并不复杂的电子环境，评估一组欧洲风湿病超声医师对互联网上发布的肌肉骨骼超声视频片段进行分级时的观察者间和观察者内一致性。
通过互联网向所有参与者提供40个短视频片段（时长少于30秒）。视频片段中包含正常和病理性类风湿关节炎手部关节及肌腱。在第一阶段，邀请来自欧洲国家的30名研究者评估这些片段并进行解读/分级。在研究开始前未举行指导会议。对于滑膜炎，要求的评分系统包括0至3级，对于腱鞘炎为二元变量0/1；对灰阶（GS）和能量多普勒（PD）检查进行单独评估。在第二阶段，要求应答者以不同顺序对相同片段进行分级，且无法查看其第一次的分级标准。使用莱特k系数和科恩k系数分析观察者间和观察者内的可靠性。
22名欧洲风湿病医师同意完成两个研究阶段。观察者内可靠性的平均科恩κ系数，腱鞘炎GS/PD为0.614/0.689，滑膜炎GS/PD为0.523/0.621。观察者间可靠性的莱特k系数，腱鞘炎评估为0.503，整体（滑膜炎和腱鞘炎）评估为0.455。平均整体总体一致性为84.95%（滑膜炎整体为90.2%）。
基于网络的超声评估和分级显示出中度至良好的可靠性。如果在研究开始时增加培训环节，结果可能会得到改善。
