Stockman Tiffany I, Kowaleski Michael P, Hicks Jacqueline M, Berns Chanel N, Saunders W Brian, McCarthy Robert J
Department of Clinical Sciences, Foster Hospital for Small Animals at Tufts Cummings School of Veterinary Medicine, North Grafton, MA, United States.
Department of Biostatistics, Boston University School of Public Health, Boston, MA, United States.
Front Vet Sci. 2025 Jul 15;12:1577046. doi: 10.3389/fvets.2025.1577046. eCollection 2025.
The purpose of this retrospective study was to determine the inter-and intra-rater agreement among novice raters, as well as agreement between novice raters and an experienced consensus using the Gächter grading scale for the evaluation of the severity of septic joints in dogs.
Three surgical residents served as novice raters, and two American College of Veterinary Surgery (ACVS) diplomates, experienced with arthroscopic evaluation of canine joints, served as the experienced consensus. Arthroscopy images were first evaluated by the experienced consensus and scored using the Gächter scale. After two supervised training sessions, novices applied the scale twice to the same images, 2 weeks apart.
The application of the Gächter grading scale was unreliable in dogs when utilized by novice raters.
Both the intra-rater agreement measured among the three novice raters and inter-rater reliability comparing the three novice raters to an expert consensus showed a consistently low concurrence among the individuals when tested at two separate time intervals. Lack of skill with arthroscopy, awareness of the anatomy and potential anatomic variations, and inadequate training in the application of the Gächter grading scheme could play a large part in a novice's ability to apply the grading scale to a septic joint. Inter-rater agreement, while initially moderate, had a decreasing concurrence between the two-time intervals.
本回顾性研究的目的是确定新手评分者之间的评分者间信度和评分者内信度，以及新手评分者与经验丰富的达成共识者之间使用盖希特分级量表评估犬类脓毒性关节严重程度的一致性。
三名外科住院医师作为新手评分者，两名美国兽医外科学院（ACVS）的专科医师作为经验丰富的达成共识者，他们对犬类关节进行关节镜评估经验丰富。关节镜图像首先由经验丰富的达成共识者进行评估，并使用盖希特量表评分。经过两次监督培训后，新手在相隔两周的时间里对相同图像应用该量表两次。
新手评分者使用盖希特分级量表对犬类进行评估时不可靠。
在两个不同时间间隔进行测试时，三名新手评分者之间的评分者内信度以及将三名新手评分者与专家共识进行比较后的评分者间信度显示，个体之间的一致性始终较低。关节镜技术不熟练、对解剖结构和潜在解剖变异的认识不足以及在应用盖希特分级方案方面的培训不足，可能在新手将分级量表应用于脓毒性关节的能力中起很大作用。评分者间信度虽然最初中等，但在两个时间间隔之间的一致性逐渐降低。
