Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, Alabama.
Neurosurgery. 2020 Jan 1;86(1):E47-E53. doi: 10.1093/neuros/nyz399.
The Colloid Cyst Risk Score (CCRS) was developed to identify symptomatic patients and stratify risk of hydrocephalus among patients with colloid cysts. Its components consider patient age, cyst diameter, presence/absence of headache, fluid-attenuated inversion recovery (FLAIR) hyperintensity, and location within the third ventricle.
To independently evaluate the inter- and intrarater reliability of the CCRS.
Patients with a colloid cyst were identified from billing records and radiology archives. Three independent raters reviewed electronic medical records to determine age, presence/absence of headache, cyst diameter (mm), FLAIR hyperintensity, and risk zone location. Raters made 53 observations, including 5 repeat observations.Fleiss' generalized kappa (κ) was calculated for all of the nominal criteria, whereas Kendall's coefficient of concordance (W) and the intraclass correlation coefficient (ICC) were calculated for the overall score.
Total CCRS score demonstrated extremely strong agreement (W = 0.83) using Kendall's W coefficient and good agreement (ICC = 0.74) using the ICC (P < .001). For interrater reliability of individual criteria, age (κ = 1.00) and FLAIR hyperintensity (κ = 0.89) demonstrated near perfect agreement. Axial diameter (κ = 0.63) demonstrated substantial agreement, whereas agreement was moderate for risk zone (κ = 0.51) and fair for headache (κ = 0.26). Intrarater reliability for total CCRS score was extremely strong using Kendall's W, good to excellent using ICC, and fair to substantial using weighted kappa.
The CCRS has good inter- and intrarater reliability when tested in an independent sample of patients, though strength of agreement varies among individual criteria. The validity of the CCRS requires independent evaluation.
胶样囊肿风险评分（CCRS）的开发目的是识别有症状的患者，并对胶样囊肿患者发生脑积水的风险进行分层。其组成部分考虑了患者年龄、囊肿直径、头痛的存在/缺失、液体衰减反转恢复（FLAIR）高信号以及第三脑室的位置。
独立评估 CCRS 的组内和组间可靠性。
从计费记录和放射学档案中确定患有胶样囊肿的患者。三位独立的评估者查看电子病历以确定年龄、头痛的存在/缺失、囊肿直径（mm）、FLAIR 高信号和风险区域位置。评估者进行了 53 次观察，包括 5 次重复观察。对所有名义标准计算了 Fleiss 广义kappa（κ），而对总评分计算了 Kendall 一致性系数（W）和组内相关系数（ICC）。
使用 Kendall 的 W 系数，总 CCRS 评分表现出极强的一致性（W=0.83），使用 ICC 则表现出较好的一致性（ICC=0.74）（P<0.001）。对于个别标准的组间可靠性，年龄（κ=1.00）和 FLAIR 高信号（κ=0.89）表现出近乎完美的一致性。轴向直径（κ=0.63）表现出显著一致性，而风险区域的一致性为中度（κ=0.51），头痛的一致性为适度（κ=0.26）。使用 Kendall 的 W 检验，总 CCRS 评分的组内可靠性极强，使用 ICC 则为良好到极好，使用加权 kappa 则为良好到中度。
在对独立患者样本进行测试时，CCRS 的组内和组间可靠性良好，但各标准的一致性强度存在差异。CCRS 的有效性需要进行独立评估。
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