Nielsen P V, Stigsby B, Nickelsen C, Nim J
Department of Obstetrics and Gynecology, Gentofte Hospital, University of Copenhagen, Denmark.
Acta Obstet Gynecol Scand. 1987;66(5):421-4. doi: 10.3109/00016348709022046.
The diagnostic value of a test depends on the variability of the test results and the accuracy of the test. The object of this investigation was to estimate the observer variability and the accuracy, when intrapartum CTGs were assessed by experienced obstetricians. Fifty CTGs were evaluated twice by four obstetricians. They were asked to identify the CTGs belonging to the compromised infants. They were told the criteria for a compromised infant and the incidence (one-third). Eleven (22%) of the CTGs were assessed in the same way of all the obstetricians in both evaluations. Between the obstetricians, the accuracy ranged from 50 to 66%. We conclude that the considerable observer variability found in this and other investigations must severely impair the clinical value of electronic fetal monitoring (EFM). The variability must be reduced before the "true" predictive value and the cost/benefit of EFM can be estimated.
一项检测的诊断价值取决于检测结果的可变性以及检测的准确性。本研究的目的是评估当经验丰富的产科医生对产时胎心监护图（CTG）进行评估时，观察者之间的可变性以及准确性。四位产科医生对50份CTG进行了两次评估。要求他们识别出属于情况不佳婴儿的CTG。告知了他们情况不佳婴儿的标准以及发生率（三分之一）。在两次评估中，所有产科医生对11份（22%）CTG的评估方式相同。在产科医生之间，准确性范围为50%至66%。我们得出结论，在本研究以及其他研究中发现的观察者之间相当大的可变性必然会严重损害电子胎儿监护（EFM）的临床价值。在能够估计EFM的“真正”预测价值和成本效益之前，必须降低这种可变性。
