Musch D C, Frueh B R, Landis J R
Ophthalmology. 1985 Sep;92(9):1177-80. doi: 10.1016/s0161-6420(85)33880-0.
In order to quantify and characterize the interobserver variation in exophthalmometry and to assess the impact of experience on that variation, four observers of varying levels of experience obtained an exophthalmometer reading from 100 subjects' right eyes and 97 subjects' left eyes. Observers were masked to the measurements of their colleagues. The subjects measured were referrals to the eye plastic and orbital service over a three week interval. Substantial interobserver variation was demonstrated. Fully one-fourth to one-third of all measurements by the three less-experienced observers differed enough from the senior observer to be of concern to him. The direction of disagreement varied with experience. The least-experienced observer consistently underread whereas the more experienced observer slightly overread exophthalmometry, relative to the senior observer. As the study progressed, the least-experienced observer's reliability increased. Interobserver agreement for this observer was influenced by the degree of proptosis presenting in the eye being measured.
为了量化和描述眼球突出度测量中观察者间的差异，并评估经验对该差异的影响，四位经验水平各异的观察者对100名受试者的右眼和97名受试者的左眼进行了眼球突出度测量读数。观察者对其同事的测量结果不知情。所测量的受试者是在三周时间内转诊至眼科整形与眼眶科的患者。结果显示观察者间存在显著差异。三位经验较少的观察者所做的全部测量中，足足四分之一到三分之一的测量结果与资深观察者的结果差异大到令其担忧。分歧的方向随经验而变化。相对于资深观察者，经验最少的观察者始终读数偏低，而经验较丰富的观察者则略偏高。随着研究的进行，经验最少的观察者的可靠性有所提高。该观察者的观察者间一致性受被测眼睛突眼程度的影响。
