Department of Otorhinolaryngology - Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Department of Otorhinolaryngology - Head and Neck Surgery, Haaglanden Medical Center, The Hague, the Netherlands.
J Laryngol Otol. 2024 Apr;138(4):425-430. doi: 10.1017/S0022215123001846. Epub 2023 Oct 26.
Fibre-optic laryngoscopy is still widely used in daily clinical practice; however, high-definition laryngoscopy using narrow band imaging could be more reliable in characterising pharyngeal and laryngeal lesions.
Endoscopic videos were assessed in a tertiary referral hospital by 12 observers with different levels of clinical experience. Thirty pairs of high-definition laryngoscopy with narrow band imaging and fibre-optic laryngoscopy videos were judged twice, with an interval of two to four weeks, in a random order. Inter- and intra-observer reliability, sensitivity and specificity were calculated in terms of detecting a malignant lesion and a specific histological entity, for beginners, trained observers and experts.
Using high-definition laryngoscopy with narrow band imaging, inter-observer reliability for detecting malignant lesions increased from moderate to substantial in trained observers and experts (high-definition laryngoscopy with narrow band imaging κ = 0.66 and κ = 0.77 fibre-optic laryngoscopy κ = 0.51 and κ = 0.56, for trained observers and experts respectively) and sensitivity increased by 16 per cent.
Inter-observer reliability increased with the level of clinical experience, especially when using high-definition laryngoscopy with narrow band imaging.
纤维喉镜在日常临床实践中仍被广泛应用；然而，窄带成像技术的高清喉镜在描述咽部和喉部病变方面可能更可靠。
在一家三级转诊医院，12 名具有不同临床经验水平的观察者对内镜视频进行评估。30 对高清窄带成像喉镜和纤维喉镜视频以随机顺序两次进行评估，两次评估间隔两到四周。初学者、训练有素的观察者和专家分别计算了检测恶性病变和特定组织学实体的检测中，观察者间和观察者内的可靠性、敏感性和特异性。
使用高清窄带成像喉镜，训练有素的观察者和专家的恶性病变检测的观察者间可靠性从中度提高到显著（高清窄带成像喉镜κ=0.66 和 κ=0.77，纤维喉镜κ=0.51 和 κ=0.56，分别为训练有素的观察者和专家），敏感性提高了 16%。
观察者间的可靠性随着临床经验水平的提高而提高，尤其是在使用高清窄带成像喉镜时。
