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新分类窄带成像在声带白斑应用中培训方案的临床实用性和有效性:一项多中心研究。

Clinical utility and effectiveness of a training programme in the application of a new classification of narrow-band imaging for vocal cord leukoplakia: A multicentre study.

机构信息

Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Department of Otolaryngology Head and Neck Surgery, Inner Mongolia North Hospital, Baotou, China.

出版信息

Clin Otolaryngol. 2019 Sep;44(5):729-735. doi: 10.1111/coa.13361. Epub 2019 Jun 19.

Abstract

OBJECTIVE

To analyse the application of a new narrow-band imaging (NBI) classification in the diagnosis of vocal cord leukoplakia by laryngologists with different levels of laryngoscopic experience and to explore the impact of NBI training programmes on laryngologists' identification of benign and malignant leukoplakia.

DESIGN

Prospective multicentre study.

SETTING

Tertiary hospitals.

PARTICIPANTS

Sixteen laryngologists were divided into less-experienced and experienced groups and received NBI training course. Thirty cases of vocal cord leukoplakia were investigated.

MAIN OUTCOME MEASURES

Diagnostic accuracy and interobserver agreement under white light imaging (WLI), before and after NBI training, were analysed among doctors with varying levels of experience.

RESULTS

The accuracy in the less-experienced group was significantly lower than that of experience group (0.59 vs 0.69) under WLI. There was no significant difference in the diagnostic accuracy between the less-experienced group and the experienced group before NBI training (0.75 vs 0.74) and after NBI training (0.79 vs 0.83). NBI training could improve the interobserver agreement from fair or moderate to good agreement.

CONCLUSION

The new NBI diagnostic classification is helpful for identifying benign and malignant vocal cord leukoplakia. In addition, the NBI training programme can improve the diagnostic accuracy and interobserver agreement of less-experienced doctors to the level of experienced laryngologists.

摘要

目的

分析不同喉镜经验水平的喉科医生应用新型窄带成像(NBI)分类诊断声带白斑的效果,探讨 NBI 培训计划对喉科医生识别良性和恶性白斑的影响。

设计

前瞻性多中心研究。

设置

三级医院。

参与者

16 名喉科医生分为经验较少组和经验丰富组,并接受 NBI 培训课程。研究了 30 例声带白斑病例。

主要观察指标

分析不同经验水平的医生在白光成像(WLI)前后的诊断准确性和观察者间一致性。

结果

在 WLI 下,经验较少组的准确率明显低于经验丰富组(0.59 比 0.69)。在接受 NBI 培训之前,经验较少组和经验丰富组的诊断准确性没有显著差异(0.75 比 0.74),在接受 NBI 培训之后也没有显著差异(0.79 比 0.83)。NBI 培训可以将观察者间的一致性从一般或中等提高到良好。

结论

新型 NBI 诊断分类有助于识别良性和恶性声带白斑。此外,NBI 培训计划可以提高经验较少医生的诊断准确性和观察者间一致性,使其达到经验丰富的喉科医生的水平。

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