Fowler John R, Hirsch David, Kruse Kevin
Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA.
Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA.
J Hand Surg Am. 2015 Oct;40(10):1992-5. doi: 10.1016/j.jhsa.2015.07.010. Epub 2015 Aug 28.
To determine the interrater and intra-rater reliability of ultrasound (US) measurement of the cross-sectional area (CSA) of the median nerve at the carpal tunnel inlet.
Three examiners of varying levels of experience performed US measurements of the CSA of the median nerve at the carpal tunnel inlet of both wrists of 11 healthy volunteers. Each examiner was blinded to the measurements of the other examiners. The measurements were repeated 2 weeks later in random order to test intra-rater reliability. The Lin concordance correlation coefficient (LCCC) for interrater and intra-rater reliability was calculated.
The overall inter-rater LCCC was 0.59 (95% confidence interval [CI], 0.41-0.73). Intra-rater LCCC varied based on examiner experience. The senior author had an intra-rater LCCC of 0.91 (95% CI, 0.80-0.96), the hand fellow had an intra-rater LCCC of 0.45 (95% CI, 0.17-0.66), and the first-year resident had an intra-rater LCCC of 0.78 (95% CI, 0.55-0.90).
There is moderate agreement among examiners of varying levels of experience when measuring the CSA of the median nerve at the carpal tunnel inlet. Examiner experience affected intra-rater reliability of measurements; an experienced examiner had nearly perfect agreement compared with moderate agreement for less experienced examiners.
确定超声（US）测量腕管入口处正中神经横截面积（CSA）的观察者间和观察者内可靠性。
三位经验水平不同的检查者对11名健康志愿者双腕的腕管入口处正中神经CSA进行超声测量。每位检查者对其他检查者的测量结果不知情。2周后以随机顺序重复测量以测试观察者内可靠性。计算观察者间和观察者内可靠性的林一致性相关系数（LCCC）。
观察者间总体LCCC为0.59（95%置信区间[CI]，0.41 - 0.73）。观察者内LCCC因检查者经验而异。资深作者的观察者内LCCC为0.91（95%CI，0.80 - 0.96），手外科专科住院医生的观察者内LCCC为0.45（95%CI，0.17 - 0.66），第一年住院医生的观察者内LCCC为0.78（95%CI，0.55 - 0.90）。
不同经验水平的检查者在测量腕管入口处正中神经CSA时存在中等程度的一致性。检查者经验影响测量的观察者内可靠性；经验丰富的检查者一致性近乎完美，而经验较少的检查者一致性为中等程度。
