Myers L E, McLelland R, Stricker C X, Feig S A, Martin J E, Moskowitz M, Nielsen M E
AJR Am J Roentgenol. 1983 Sep;141(3):445-50. doi: 10.2214/ajr.141.3.445.
Wolfe's mammographic classification and a percentage classification are statistically evaluated for inter- and intraobserver bias and agreement by seven mammographers with a set of 200 xeromammograms. The results demonstrate significant bias and disagreement with both methods, raising questions about the clinical limitations of these or other mammographic classifications. However, about 90% of the percentage classifications of pairs of readers are within adjacent categories. This suggests that (1) more experience with precisely defined classifications and protocols, (2) the development and application of readily available instructional materials, and (3) studies to identify and evaluate sources of variation in such classifications may eventually lead to acceptable levels of reproducibility.
七名乳腺造影师使用一组200张干板乳腺造影片，对沃尔夫乳腺造影分类法和百分比分类法进行了观察者间和观察者内偏差及一致性的统计学评估。结果表明这两种方法均存在显著偏差和不一致性，这引发了对这些或其他乳腺造影分类法临床局限性的质疑。然而，约90%的成对读者的百分比分类处于相邻类别内。这表明：（1）对精确界定的分类法和方案有更多经验；（2）开发并应用易于获取的指导材料；（3）开展研究以识别和评估此类分类法中的变异来源，最终可能会实现可接受的再现性水平。
