Longfield J N, Margileth A M, Golden S M, Lazoritz S, Bohan J S, Cruess D F
Pediatr Infect Dis. 1984 Jul-Aug;3(4):323-6. doi: 10.1097/00006454-198407000-00010.
Accurate measurement and interpretation of tuberculin skin tests is essential both to avoid unnecessary prophylactic treatment with potentially hepatotoxic drugs and to ensure the proper institution of therapy in tuberculin-positive individuals. Although two methods are currently used for reading tuberculin skin tests, palpation and ballpoint, the optimal technique has not been established. We compared measurements obtained by each method on 101 patients tested with intermediate tuberculin purified protein derivative. Fifty-eight of these patients were also tested using Mono-Vacc. Excellent interobserver agreement among the five raters was demonstrated for both the palpation and ballpoint techniques. There was no significant difference between the two methods for any reader using the normal 10-mm cutoff point for a positive intermediate tuberculin purified protein derivative test. For any individual observer the decision as to whether the test was positive or negative was unaffected by the method in at least 93% of readings. We conclude that readings by physicians using palpation and ballpoint methods are comparable for clinical decision making.
准确测量和解读结核菌素皮肤试验对于避免使用可能具有肝毒性的药物进行不必要的预防性治疗以及确保对结核菌素呈阳性的个体正确实施治疗至关重要。尽管目前有两种方法用于读取结核菌素皮肤试验结果，即触诊法和圆珠笔标记法，但尚未确定最佳技术。我们比较了101例接受中等强度结核菌素纯蛋白衍生物检测的患者使用每种方法所获得的测量结果。其中58例患者还使用了单苗卡介苗进行检测。对于触诊法和圆珠笔标记法，五位评估者之间均显示出极好的观察者间一致性。对于使用正常10毫米临界值判断中等强度结核菌素纯蛋白衍生物试验呈阳性的任何一位读者而言，两种方法之间均无显著差异。对于任何一位个体观察者，在至少93%的读数中，判断试验呈阳性或阴性不受方法的影响。我们得出结论，医生使用触诊法和圆珠笔标记法进行的读数在临床决策方面具有可比性。
