Choa R M, Giele H P
Department of Plastic Reconstructive and Hand Surgery, Oxford University Hospitals, Oxford, UK.
Department of Plastic Reconstructive and Hand Surgery, Oxford University Hospitals, Oxford, UK.
J Hand Surg Am. 2015 Jan;40(1):23-6. doi: 10.1016/j.jhsa.2014.09.007. Epub 2014 Oct 14.
To assess the reliability of the Eaton and Glickel classification for base of thumb osteoarthritis.
The interrater and intrarater reliability of this classification were assessed by comparing ratings from 6 raters using quadratic weighted kappa scores.
Median inter-rater reliability ranged from kappa of .53 to .54; intrarater reliability ranged from kappa of .60 to .82. Using unweighted kappa interrater reliability was "slightly" reliable, and intrarater reliability was "fairly" reliable. Overall, the value of the intraclass correlation for all 6 raters was .56.
This radiological classification does not describe all stages of carpometacarpal joint osteoarthritis accurately enough to permit reliable and consistent communication between clinicians. Therefore we believe it should be used with an understanding of its limitations when communicating disease severity between clinicians or as a tool to assist in clinical decision making.
评估伊顿（Eaton）和格利克尔（Glickel）对拇指基底骨关节炎分类的可靠性。
通过比较6位评估者使用二次加权kappa分数得出的评级，评估该分类的评估者间信度和评估者内信度。
评估者间信度中位数的kappa值范围为0.53至0.54；评估者内信度的kappa值范围为0.60至0.82。使用非加权kappa时，评估者间信度为“轻微”可靠，评估者内信度为“相当”可靠。总体而言，所有6位评估者的组内相关系数值为0.56。
这种影像学分类不能足够准确地描述腕掌关节骨关节炎的所有阶段，无法在临床医生之间实现可靠且一致的沟通。因此，我们认为在临床医生之间交流疾病严重程度时，使用该分类应了解其局限性，或者将其作为辅助临床决策的工具。
