耳鼻喉科医生在小儿气道炎症评估方面的一致性较低。
Otolaryngologists Demonstrate Low Agreement on Pediatric Airway Inflammation Assessment.
作者信息
Raj Sweeya V, Prosak Olivia L, O'Brien Kaitlin July, Park Jason S, Zhao Shilin, Wootten Christopher T
机构信息
Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Department of Otolaryngology - Head and Neck Surgery, Pediatrics Division, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
出版信息
Laryngoscope. 2025 May;135(5):1830-1835. doi: 10.1002/lary.31926. Epub 2024 Nov 23.
OBJECTIVES
Microlaryngoscopy and bronchoscopy (MLB) are essential tools for evaluating airway inflammation, but the reliability of endoscopic assessments for this purpose remains unclear. The aim of this study was to assess surgeons' interrater reliability during endoscopic assessment of airway inflammation. The endoscopic factors used to determine overall airway inflammation were also assessed.
METHODS
We conducted a cross-sectional study involving 24 pediatric patients who underwent MLB and arytenoid biopsy. Surgeons rated airway inflammation based on endoscopic images, and interrater reliability was assessed using Fleiss' Kappa.
RESULTS
Fleiss's Kappa demonstrated poor interrater reliability among all surgeons (0.111) and experienced surgeons (0.117). Surgeons varied in prioritizing visual features for assessing inflammation.
CONCLUSION
Current subjective assessments of airway inflammation during MLB exhibit poor interrater reliability, necessitating further research for improved diagnostic accuracy and informed treatment decisions in pediatric airway interventions.
LEVEL OF EVIDENCE
3 Laryngoscope, 135:1830-1835, 2025.
目的
显微喉镜检查和支气管镜检查（MLB）是评估气道炎症的重要工具，但内镜评估在此目的上的可靠性仍不明确。本研究的目的是评估外科医生在气道炎症内镜评估中的评分者间信度。还评估了用于确定整体气道炎症的内镜因素。
方法
我们进行了一项横断面研究，纳入了24例接受MLB和杓状软骨活检的儿科患者。外科医生根据内镜图像对气道炎症进行评分，并使用Fleiss' Kappa评估评分者间信度。
结果
Fleiss' Kappa显示所有外科医生之间（0.111）以及经验丰富的外科医生之间（0.117）的评分者间信度较差。外科医生在评估炎症的视觉特征优先级方面存在差异。
结论
目前MLB期间对气道炎症的主观评估显示评分者间信度较差，需要进一步研究以提高儿科气道干预中的诊断准确性和明智的治疗决策。
证据水平
3 《喉镜》，135:1830 - 1835，2025年。
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