Musch D C, Landis J R, Higgins I T, Gilson J C, Jones R N
Stat Med. 1984 Jan-Mar;3(1):73-83. doi: 10.1002/sim.4780030109.
We investigated interobserver variation between three physician readers in the independent classification of chest radiographs from 1771 taconite workers for pneumoconiosis. We analysed variation with a general methodology for the analysis of categorical data, and quantified interobserver agreement in terms of kappa-type statistics. The results revealed considerable variation in the profusion of opacities reported by each observer. This was especially so for the earliest radiographic changes, but variation also occurred with the small number of films in the series showing category 2 pneumoconiosis or over. Variation in the classification of profusion of small opacities was greater in films of poor quality, and also increased with the length of time between taking and reading the film (film age). We could not account for the effect of film age by controlling for film quality, as subjectively assessed by the readers.
我们调查了三位医生阅片者在对1771名铁燧岩矿工的胸部X光片进行尘肺病独立分类时的观察者间差异。我们使用一种用于分析分类数据的通用方法来分析差异，并根据kappa型统计量对观察者间的一致性进行量化。结果显示，每位观察者报告的阴影密集度存在相当大的差异。对于最早的影像学改变尤其如此，但在该系列中显示2级或更高级别尘肺病的少数片子中也存在差异。小阴影密集度分类的差异在质量较差的片子中更大，并且也随着拍片与阅片之间的时间间隔（片子年龄）增加而增大。我们无法通过控制读者主观评估的片子质量来解释片子年龄的影响。
