Kohler T, Langlois Y, Roederer G O, Phillips D J, Beach K W, Primozich J, Lawrence R, Nicholls S C, Strandness D E
Ultrasound Med Biol. 1985 Jul-Aug;11(4):571-6. doi: 10.1016/0301-5629(85)90027-4.
Interobserver and intraobserver variability of ultrasonic, duplex carotid artery examinations was studied in a prospective, randomized, and blinded clinical trial. Forty-eight patients were examined by two technologists, yielding 96 carotid artery examinations. The kappa statistic was calculated to determine the degree of agreement corrected for chance. The kappa value between examinations by different technologists was 0.476. Variability occurred at both steps in the examination procedure: (1) obtaining the velocity waveforms (kappa = 0.536); and (2) using these waveforms to classify the extent of carotid disease (kappa = 0.609 for interobserver variability in reading waveforms). Minimal to moderate disease categories accounted for most of the variability. There was little disagreement in categorizing lesions as greater than or less than 50% diameter reduction. Intraobserver variability in rereading spectral waveforms was minimal (kappa = 0.842 and 0.894). Recognition of disturbed flow patterns in normal carotid bulbs may reduce variability.
在一项前瞻性、随机、双盲临床试验中，研究了超声双功能颈动脉检查的观察者间和观察者内变异性。48名患者由两名技术人员进行检查，共进行了96次颈动脉检查。计算kappa统计量以确定校正机遇后的一致程度。不同技术人员检查之间的kappa值为0.476。检查过程的两个步骤均出现变异性：（1）获取速度波形（kappa = 0.536）；（2）使用这些波形对颈动脉疾病的程度进行分类（阅读波形时观察者间变异性的kappa = 0.609）。最小至中度疾病类别占变异性的大部分。在将病变分类为直径减少大于或小于50%方面几乎没有分歧。重新读取频谱波形时观察者内变异性最小（kappa = 0.842和0.894）。识别正常颈动脉球部的紊乱血流模式可能会降低变异性。
