Egido Jose A, Garcia Ana M, Del Prado-Gonzalez Náyade, Fuentes-Ferrer Manuel, Lopez-Herranz Marta, Simal-Hernández Patricia, Fernández-Pérez Cristina
Stroke Unit and Neurosonology Laboratory, Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdSSC), Madrid, Spain.
Acute Stroke Unit, Worcestershire Royal Hospital, Worcester, United Kingdom.
J Clin Ultrasound. 2016 Nov 12;44(9):571-579. doi: 10.1002/jcu.22379. Epub 2016 Aug 4.
Sonographic tests are observer-dependent. With 1,527 consecutive patients, 22 trainees were assessed at baseline and after a hands-on 1:1 program, with a pre-examination median of 76 studies/trainee. We evaluated the required number of supervised examinations to reach a 0.80 kappa index (ki). Statistics included linear and exponential generalized estimating equation models. In the exponential model, 76 studies for carotid-duplex and >102 for vertebral-duplex and transcranial Doppler were needed for a 0.80 ki. "Relevant-categories" after-training ki was 0.80 in carotid-duplex and transcranial Doppler but 0.60 in vertebral-duplex. A fixed training does not guarantee a high ki. Measuring the acquired skills of every trainee would improve quality. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:571-579, 2016.
超声检查依赖于观察者。对1527例连续患者，在基线时以及经过一对一实践培训项目后对22名实习生进行了评估，每位实习生检查前的中位数为76项研究。我们评估了达到0.80的kappa指数（ki）所需的监督检查数量。统计方法包括线性和指数广义估计方程模型。在指数模型中，颈动脉双功超声需要76项研究，椎动脉双功超声和经颅多普勒需要超过102项研究才能达到0.80的ki。培训后颈动脉双功超声和经颅多普勒的“相关类别”ki为0.80，但椎动脉双功超声为0.60。固定的培训并不能保证高ki。对每位实习生的所学技能进行评估将提高质量。©2016威利期刊公司。《临床超声杂志》2016年第44卷：571 - 579页。
