Ramalho J N, Tedesqui G, Ramalho M, Azevedo R S, Castillo M
From the Departments of Neuroradiology (J.N.R., G.T., M.C.) Centro Hospitalar de Lisboa Central (J.N.R.), Lisbon, Portugal
From the Departments of Neuroradiology (J.N.R., G.T., M.C.).
AJNR Am J Neuroradiol. 2015 Jun;36(6):1039-42. doi: 10.3174/ajnr.A4242. Epub 2015 Feb 12.
Because evidence-based articles are difficult to recognize among the large volume of publications available, some journals have adopted evidence-based medicine criteria to classify their articles. Our purpose was to determine whether an evidence-based medicine classification used by a subspecialty-imaging journal allowed consistent categorization of levels of evidence among different raters.
One hundred consecutive articles in the American Journal of Neuroradiology were classified as to their level of evidence by the 2 original manuscript reviewers, and their interobserver agreement was calculated. After publication, abstracts and titles were reprinted and independently ranked by 3 different radiologists at 2 different time points. Interobserver and intraobserver agreement was calculated for these radiologists.
The interobserver agreement between the original manuscript reviewers was -0.2283 (standard error = 0.0000; 95% CI, -0.2283 to -0.2283); among the 3 postpublication reviewers for the first evaluation, it was 0.1899 (standard error = 0.0383; 95% CI, 0.1149-0.2649); and for the second evaluation, performed 3 months later, it was 0.1145 (standard error = 0.0350; 95% CI, 0.0460-0.1831). The intraobserver agreement was 0.2344 (standard error = 0.0660; 95% CI, 0.1050-0.3639), 0.3826 (standard error = 0.0738; 95% CI, 0.2379-0.5272), and 0.6611 (standard error = 0.0656; 95% CI, 0.5325-0.7898) for the 3 postpublication evaluators, respectively. These results show no-to-fair interreviewer agreement and a tendency to slight intrareviewer agreement.
Inconsistent use of evidence-based criteria by different raters limits their utility when attempting to classify neuroradiology-related articles.
鉴于在大量可得的出版物中难以识别循证医学文章，一些期刊采用循证医学标准对其文章进行分类。我们的目的是确定一本影像亚专业期刊所采用的循证医学分类方法能否让不同评分者对证据水平进行一致的分类。
《美国神经放射学杂志》上的100篇连续文章由两位原始稿件评审者对其证据水平进行分类，并计算他们之间的观察者间一致性。文章发表后，摘要和标题被重新印发，并由3位不同的放射科医生在2个不同时间点独立进行排序。计算这些放射科医生的观察者间一致性和观察者内一致性。
原始稿件评审者之间的观察者间一致性为-0.2283（标准误=0.0000；95%置信区间，-0.2283至-0.2283）；在3位发表后首次评估的评审者中，一致性为0.1899（标准误=0.0383；95%置信区间，0.1149 - 0.2649）；在3个月后进行的第二次评估中，一致性为0.1145（标准误=0.0350；95%置信区间，0.0460 - 0.1831）。3位发表后评估者的观察者内一致性分别为0.2344（标准误=0.0660；95%置信区间，0.1050 - 0.3639）、0.3826（标准误=0.0738；95%置信区间，0.2379 - 0.5272）和0.6611（标准误=0.0656；95%置信区间，0.5325 - 0.7898）。这些结果显示出评审者间一致性差至一般，且有观察者内一致性轻微增加的趋势。
不同评分者对循证医学标准的使用不一致，限制了其在对神经放射学相关文章进行分类时的效用。
