. Universidade do Estado de Santa Catarina - UDESC - Florianópolis (SC) Brasil.
. Universidade Federal de Santa Catarina - UFSC - Florianópolis (SC) Brasil.
J Bras Pneumol. 2018 May-Jun;44(3):220-226. doi: 10.1590/S1806-37562016000000131.
To investigate the concurrent validity, as well as the intra- and inter-rater reliability, of assessing diaphragmatic mobility by area (DMarea) on chest X-rays of healthy adults.
We evaluated anthropometric parameters, pulmonary function, and diaphragmatic mobility in 43 participants. Two observers (rater A and rater B) determined diaphragmatic mobility at two time points. We used Pearson's correlation coefficient to evaluate the correlation between DMarea and the assessment of diaphragmatic mobility by distance (DMdist). To evaluate intra- and inter-rater reliability, we used the intraclass correlation coefficient (ICC [2,1]), 95% CI, and Bland-Altman analysis.
A significant correlation was found between the DMarea and DMdist methods (r = 0.743; p < 0.0001). For DMarea, the intra-rater reliability was found to be quite high for the right hemidiaphragm (RHD)-ICC (2,1) = 0.92 (95% CI: 0.86-0.95) for rater A and ICC (2,1) = 0.90 (95% CI: 0.84-0.94) for rater B-and the left hemidiaphragm (LHD)-ICC (2,1) = 0.96 (95% CI: 0.93-0.97) for rater A and ICC (2,1) = 0.91 (95% CI: 0.81-0.95) for rater B-(p < 0.0001 for all). Also for DMarea, the inter-rater reliability was found to be quite high for the first and second evaluations of the RHD-ICC (2,1) = 0.99 (95% CI: 0.98-0.99) and ICC (2,1) = 0.95 (95% CI: 0.86-0.97), respectively-and the LHD-ICC (2,1) = 0.99 (95% CI: 0.98-0.99) and ICC (2,1) = 0.94 (95% CI: 0.87-0.97)-(p < 0.0001 for both). The Bland-Altman analysis showed good agreement between the mobility of the RHD and that of the LHD.
The DMarea method proved to be a valid, reliable measure of diaphragmatic mobility.
研究评估健康成年人胸部 X 射线膈肌移动度的面积（DMarea）的同时效度，以及内部和外部观察者的可靠性。
我们评估了 43 名参与者的人体测量参数、肺功能和膈肌移动度。两位观察者（评估者 A 和评估者 B）在两个时间点确定膈肌移动度。我们使用皮尔逊相关系数评估 DMarea 与通过距离（DMdist）评估膈肌移动度之间的相关性。为了评估内部和外部观察者的可靠性，我们使用组内相关系数（ICC [2,1]）、95%置信区间和 Bland-Altman 分析。
DMarea 方法与 DMdist 方法之间存在显著相关性（r = 0.743；p < 0.0001）。对于 DMarea，右膈肌（RHD）的内部观察者可靠性非常高-评估者 A 的 ICC（2,1）= 0.92（95%CI：0.86-0.95）和评估者 B 的 ICC（2,1）= 0.90（95%CI：0.84-0.94）-以及左膈肌（LHD）的 ICC（2,1）= 0.96（95%CI：0.93-0.97）和评估者 B 的 ICC（2,1）= 0.91（95%CI：0.81-0.95）（均为 p < 0.0001）。对于 DMarea，第一次和第二次 RHD 评估的外部观察者可靠性也非常高-ICC（2,1）= 0.99（95%CI：0.98-0.99）和 ICC（2,1）= 0.95（95%CI：0.86-0.97）-以及 LHD 的 ICC（2,1）= 0.99（95%CI：0.98-0.99）和 ICC（2,1）= 0.94（95%CI：0.87-0.97）（均为 p < 0.0001）。Bland-Altman 分析显示 RHD 和 LHD 的移动性之间具有良好的一致性。
DMarea 方法被证明是一种有效的、可靠的膈肌移动度测量方法。
