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临床经验是否会影响颈椎成熟度方法的可重复性?

Does clinical experience affect the reproducibility of cervical vertebrae maturation method?

作者信息

Rongo Roberto, Valleta Rosa, Bucci Rosaria, Bonetti Giulio Alessandri, Michelotti Ambrosina, D'Antò Vincenzo

机构信息

a   Postdoctoral student, School of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Napes, Italy.

b   Associate Professor, School of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Naples, Italy.

出版信息

Angle Orthod. 2015 Sep;85(5):841-7. doi: 10.2319/080414-544.1. Epub 2015 Jan 26.

Abstract

OBJECTIVE

To assess interobserver and intraobserver reproducibility of the cervical vertebrae maturation method (CVMM) among three panels of judges with different levels of orthodontic experience (OE).

MATERIALS AND METHODS

Fifty individual lateral cephalograms of good quality with complete visualization of cervical vertebrae 1 to 4 were selected. Thirty clinicians, divided according to their OE into three groups (junior group, JU, OE ≤ 1 year; postgraduate group, PG, 2 ≤ OE ≤ 4 years; specialist group, SP, OE ≥ 7 years), evaluated the cephalograms in two sessions (T1 and T2) at 3 weeks apart. Kendall's W and weighted Cohen's kappa (κ) coefficients were performed to assess interobserver and intraobserver agreement. The level of significance was set as P < .05. For both the interobserver and the intraobserver datasets, the percentage of perfect agreement (PPA) and the number of stages apart for each disagreement were calculated.

RESULTS

Kendall's W at T1 was SP  =  0.61, PG  =  0.70, and JU  =  0.87; at T2 it was SP  =  0.78, PG  =  0.85, and JU  =  0.86. The percentage of total interobserver perfect agreement (Inter-PPA) was 42.3% at T1 and 46.3% at T2. The JU group had the highest Cohen's κ coefficient at 0.78, while the PG and SP had coefficients of 0.64 each. The percentage of total intraobserver perfect agreement (Intra-PPA) was 54.2%.

CONCLUSIONS

The reproducibility of the method was not improved by the level of orthodontic experience. The group with the lowest level of orthodontic experience had the best performance.

摘要

目的

评估颈椎成熟度方法(CVMM)在三组具有不同正畸经验(OE)水平的评判人员之间及评判人员自身内部的可重复性。

材料与方法

选取50张质量良好、能完整显示第1至4颈椎的个体头颅侧位片。30名临床医生,根据其正畸经验分为三组(初级组,JU,OE≤1年;研究生组,PG,2≤OE≤4年;专家组,SP,OE≥7年),在相隔3周的两个时间段(T1和T2)对头颅侧位片进行评估。采用肯德尔W系数和加权科恩kappa(κ)系数来评估评判人员之间及评判人员自身内部的一致性。显著性水平设定为P < 0.05。对于评判人员之间及评判人员自身内部的数据集,计算完全一致的百分比(PPA)以及每次不一致时相差的阶段数。

结果

T1时肯德尔W系数,SP = 0.61,PG = 0.70,JU = 0.87;T2时,SP = 0.78,PG = 0.85,JU = 0.86。评判人员之间完全一致的总百分比(组间PPA)在T1时为42.3%,在T2时为46.3%。JU组的科恩κ系数最高,为0.78,而PG组和SP组的系数均为0.64。评判人员自身内部完全一致的总百分比(组内PPA)为54.2%。

结论

正畸经验水平并未提高该方法的可重复性。正畸经验水平最低的组表现最佳。

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