Gjørup T, Agner E, Jensen L B, Jensen A M, Møllmann K M
Scand J Gastroenterol. 1986 Apr;21(3):261-7. doi: 10.3109/00365528609003074.
In a randomized design we examined whether endoscopists are biased by knowledge of the radiologic diagnosis of duodenal ulcer and deformity of the duodenal bulb when recording the corresponding endoscopic diagnoses. A total of 156 patients had a barium meal and were subsequently randomized into 2 groups. In 74 of the cases the 2 endoscopists knew the result of the X-ray examination when doing the endoscopy; in 82 of the cases they did not. One endoscopist was significantly biased by his knowledge of the radiologic diagnosis of deformity of the duodenal bulb. Neither of the endoscopists was biased by his knowledge of the radiologic diagnosis of duodenal ulcer. In addition, the interobserver variation between the two endoscopists with regard to the endoscopic diagnoses of duodenal ulcer, deformity of the duodenal bulb, and duodenitis was examined. The interobserver variation was expressed by the overall agreement and by the kappa statistics, which adjusts the overall agreement for expected chance agreement. For duodenal ulcer, deformity of the duodenal bulb, and duodenitis, the overall agreements and kappa values were 0.91, 0.78, and 0.75, and 0.54, 0.42, and 0.33, respectively.
在一项随机设计中，我们研究了内镜医师在记录十二指肠溃疡和十二指肠球部畸形的相应内镜诊断时，是否会受到十二指肠溃疡放射学诊断知识的影响。共有156例患者进行了钡餐检查，随后被随机分为2组。在74例病例中，2名内镜医师在进行内镜检查时知道X线检查结果；在82例病例中，他们不知道。一名内镜医师明显受到其对十二指肠球部畸形放射学诊断知识的影响。两名内镜医师均未受到其对十二指肠溃疡放射学诊断知识的影响。此外，还检查了两名内镜医师在十二指肠溃疡、十二指肠球部畸形和十二指肠炎内镜诊断方面的观察者间差异。观察者间差异通过总体一致性和kappa统计量来表示，kappa统计量会根据预期的偶然一致性对总体一致性进行调整。对于十二指肠溃疡、十二指肠球部畸形和十二指肠炎，总体一致性和kappa值分别为0.91、0.78和0.75，以及0.54、0.42和0.33。
