Geissbühler U, Drazovic S, Lang J, Howard J
Clinical Radiology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland.
Diagnostic Clinical Laboratory, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland.
Vet Rec. 2017 Apr 8;180(14):357. doi: 10.1136/vr.104053. Epub 2017 Jan 11.
The objective was to determine the agreement between scrutineers assessing canine hip dysplasia (CHD) within and between the Fédération Cynologique Internationale (FCI) and the Swiss (CH) grading schemes, and between first-opinion and second-opinion scrutineers using the CH scheme. 62 scrutineers, participating in a quality assessment programme, were asked to evaluate 12 sets of hip radiographs. All radiographs had been previously evaluated by a first-opinion and 7 by both a first-opinion and second-opinion scrutineers using the CH scheme. Inter-rater agreement (κ) and intraclass correlation (ICC) were evaluated for the Norberg angle and dysplasia grades, and ICC for the numerical CH scores. The κ and ICC were 0.290 and 0.471 for Norberg angles, 0.372 and 0.577 for FCI grades, and 0.417 and 0.567 for CH grades, respectively. The ICC for CH scores was 0.614. Total agreement for grades was found in a single case. For radiographs evaluated using both schemes, raters gave the same grade in 441 cases, a lower FCI than CH grade in 78 cases and a lower CH than FCI grade in 32 cases. Intrarater agreement between grades of the two schemes was 0.786. Agreement between the first-opinion and second-opinion scrutineers was 0.250 for Norberg angles and -0.286 for CH grades. Although agreement between the two schemes was good, agreement between scrutineers using either scheme was only fair to moderate, and no agreement was found between first-opinion and second-opinion scrutineers. Application of the FCI and CH schemes may impact the incidence of hip dysplasia in populations with both severe and moderate dysplasia, but is unlikely to impact populations with only mild dysplasia. The CH system of first-opinion and second-opinion examinations should be re-evaluated.
目的是确定在国际犬业联合会（FCI）和瑞士（CH）分级方案内部及之间，以及使用CH方案的初诊和复诊审查员之间，评估犬髋关节发育不良（CHD）的审查员之间的一致性。62名参与质量评估计划的审查员被要求评估12组髋关节X光片。所有X光片此前都已由一名初诊审查员进行过评估，其中7组还由一名使用CH方案的初诊和复诊审查员进行过评估。对诺伯格角和发育不良等级评估了评分者间一致性（κ）和组内相关系数（ICC），对CH数值评分评估了ICC。诺伯格角的κ和ICC分别为0.290和0.471，FCI等级的κ和ICC分别为0.372和0.577，CH等级的κ和ICC分别为0.417和0.567。CH评分的ICC为0.614。仅在一个案例中发现等级完全一致。对于使用两种方案评估的X光片，评分者在441个案例中给出了相同等级，78个案例中FCI等级低于CH等级，32个案例中CH等级低于FCI等级。两种方案等级之间的评分者内一致性为0.786。初诊和复诊审查员之间，诺伯格角的一致性为0.250，CH等级的一致性为 -0.286。尽管两种方案之间的一致性良好，但使用任一方案的审查员之间的一致性仅为一般到中等，初诊和复诊审查员之间未发现一致性。FCI和CH方案的应用可能会影响重度和中度发育不良群体中髋关节发育不良的发病率，但不太可能影响仅轻度发育不良的群体。CH初诊和复诊检查系统应重新评估。
