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脑瘫儿童髋关节迁移指数的观察者间和观察者内可靠性受临床医生经验和专业知识的影响:一项符合 STROBE 准则的回顾性研究。

Effect of clinician's experience and expertise on the inter- and intra-observer reliability of hip migration index in children with cerebral palsy: A STROBE-compliant retrospective study.

机构信息

Department of Orthopaedics and Traumatology, Biruni University, School of Medicine.

Department of Orthopaedics and Traumatology, İstanbul University, Istanbul School of Medicine.

出版信息

Medicine (Baltimore). 2021 Mar 12;100(10):e24538. doi: 10.1097/MD.0000000000024538.

Abstract

Few studies have investigated the reliability of Reimers' hip migration percentage (RMP) in children with cerebral palsy (CP). Most studies on the topic reflected rating results of physician with a similar level of experience from the same expertise. This study aimed to determine the effect of clinician's experience and expertise on the intra-and inter-observer reliability of RMP.In this retrospective observational study, hip radiographs of children with CP were identified. 5 observers with different degrees of working experience from 3 different clinical fields, including orthopedics, radiology, and physical medicine and rehabilitation, performed all RMP measurements. All measurements were repeated 6 weeks later by the same observers. Inter- and intra-observer reliability for RMP measurements were assessed using Intraclass Correlation Coeficient (ICC), calculated from 2 sets of repeated measurements on a subset of 50 hips, with a 6 week apart for each observer.Fifty hip radiographs of 25 children with CP (10 females and 15 males; mean age: 6 years; age range: 2-8 years) were examined in the current study. No significant differences existed in intra-and inter-observer measurements. Excellent intra-observer reliability was observed between the 2 separate measurements for each observer, with a mean ICC of 0.976 (range: 0.956-0.989; P < .001). Among 5 observers, inter-observer reliability was excellent for the 2 separate RMP measurements, with the mean ICC minimally increasing between the 2 measurement periods (mean ICC: 0.928, range: 0.838-0.979 and mean ICC: 0.936, range: 0.861-0.983, respectively) (P < .001).Clinician's experience and expertise may not affect inter-and intra-observer reliability of RMP measurements.

摘要

很少有研究调查雷默氏髋关节移百分比(RMP)在脑瘫(CP)儿童中的可靠性。大多数关于该主题的研究反映了具有相似经验水平的医生的评分结果,这些医生来自同一专业领域。本研究旨在确定临床医生的经验和专业知识对 RMP 测量的观察者内和观察者间可靠性的影响。

在这项回顾性观察研究中,确定了患有 CP 的儿童的髋关节 X 光片。来自 3 个不同临床领域(骨科、放射科和物理医学与康复)的 5 名具有不同工作经验程度的观察者对所有 RMP 进行了测量。所有测量均由同一名观察者在 6 周后重复进行。使用组内相关系数(ICC)评估 RMP 测量的观察者内和观察者间可靠性,ICC 是从 50 髋的子集中的 2 组重复测量值计算得出的,每位观察者的测量值之间相隔 6 周。

在当前研究中,检查了 25 名患有 CP 的儿童(10 名女性和 15 名男性;平均年龄:6 岁;年龄范围:2-8 岁)的 50 张髋关节 X 光片。观察者内和观察者间测量均无显著差异。每位观察者的 2 次独立测量均观察到极好的观察者内可靠性,平均 ICC 为 0.976(范围:0.956-0.989;P<.001)。在 5 名观察者中,对于 2 次 RMP 测量,2 次独立测量的观察者间可靠性均为极好,在 2 次测量期间平均 ICC 略有增加(平均 ICC:0.928,范围:0.838-0.979 和平均 ICC:0.936,范围:0.861-0.983,分别)(P<.001)。

临床医生的经验和专业知识可能不会影响 RMP 测量的观察者内和观察者间可靠性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab56/7969294/4862045a5fea/medi-100-e24538-g001.jpg

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