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硬皮病模式的再现性评估通过宽场共聚焦显微镜在患有雷诺现象的受试者中。

Reproducibility of the scleroderma pattern assessed by wide-field capillaroscopy in subjects suffering from Raynaud's phenomenon.

机构信息

Service de Médecine Vasculaire, Hôpital Saint-André, Bordeaux.

Service de Médecine Vasculaire, CHU de Grenoble-Alpes, La Tronche.

出版信息

Rheumatology (Oxford). 2017 Oct 1;56(10):1780-1783. doi: 10.1093/rheumatology/kex282.

Abstract

OBJECTIVES

The aim of this work was to study inter- and intra-observer agreement for the diagnosis of scleroderma pattern by wide-field capillaroscopy.

METHODS

Images were taken from 50 patients known to have SSc and 50 controls consulting for RP who did not have SSc. These images were rated simultaneously by 11 experienced vascular medicine physicians as scleroderma pattern or not. Two weeks later, 7 of the 11 observers again rated the same images.

RESULTS

Inter-observer agreement was almost perfect between the 11 observers (κ 0.86 ± 0.01), and the proportion of concordant observations was 79% (70-87). When each observer was compared with the reference, agreement was also almost perfect: κ coefficient 0.92 ± 0.03 and proportion of concordant observations 79% (70-87). Intra-observer agreement was also almost perfect: median κ coefficient 0.94 (0.78-0.96) and median proportion of concordant observations 97% (89-98).

CONCLUSION

Excellent inter- and intra-observer agreement was obtained in experienced vascular physicians for the diagnosis of capillaroscopic landscape by wide-field nailfold capillary microscopy.

摘要

目的

本研究旨在通过宽视野甲襞毛细血管显微镜检查评估硬皮病模式的诊断中观察者间和观察者内的一致性。

方法

从 50 例已知患有 SSc 的患者和 50 例因 RP 就诊但未患有 SSc 的对照者中获取图像。这组图像由 11 名具有丰富血管医学经验的医生同时评估为硬皮病模式或非硬皮病模式。两周后,其中 7 名观察者再次评估了相同的图像。

结果

11 名观察者之间的观察者间一致性几乎为完美(κ 值 0.86±0.01),一致观察的比例为 79%(70%-87%)。当每个观察者与参考标准进行比较时,一致性也几乎为完美:κ 值为 0.92±0.03,一致观察的比例为 79%(70%-87%)。观察者内一致性也几乎为完美:中位数κ值为 0.94(0.78-0.96),一致观察的中位数比例为 97%(89%-98%)。

结论

在具有丰富血管医学经验的医生中,通过宽视野甲襞毛细血管显微镜检查诊断毛细血管镜下的景观获得了极好的观察者间和观察者内的一致性。

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