Guth A, Coste J, Chagnon S, Lacombe P, Paolaggi J B
Department of Radiology, Ambroise Paré Hospital, Boulogne, France.
Invest Radiol. 1995 Mar;30(3):181-5. doi: 10.1097/00004424-199503000-00008.
To assess the intraobserver reliability of three methods used frequently to evaluate joint destruction in rheumatoid arthritis: the Sharp method, the Larsen method, and the carpo:metacarpal ratio.
One observer analyzed twice within a 6-week interval 71 radiographs from patients with rheumatoid arthritis. Reliability was estimated by intraclass correlation coefficient (R) and by Altman-Bland graphical method. Correlations were examined by the Spearman's coefficient (r).
The intraobserver reliability of each method appeared satisfactory with a good result for the Sharp method (R = 0.97). The correlation was strong (r > 0.80) between the results obtained by Sharp's and Larsen's methods and weaker between the results of the two former methods and the carpo: metacarpal ratio.
Sharp's method should be used preferentially in studies evaluating the radiologic changes in rheumatoid arthritis over time, especially in clinical trials. The carpo:metacarpal ratio may be considered as a complementary method, when wrist destruction is of conceptual importance.
评估类风湿关节炎中常用于评估关节破坏的三种方法的观察者内可靠性：夏普方法、拉森方法和腕掌比。
一名观察者在6周内对71例类风湿关节炎患者的X光片进行了两次分析。通过组内相关系数（R）和奥特曼-布兰德图形法估计可靠性。通过斯皮尔曼系数（r）检验相关性。
每种方法的观察者内可靠性看起来令人满意，夏普方法结果良好（R = 0.97）。夏普方法和拉森方法所得结果之间相关性很强（r > 0.80），前两种方法与腕掌比之间的相关性较弱。
在评估类风湿关节炎随时间变化的放射学改变的研究中，尤其是在临床试验中，应优先使用夏普方法。当腕关节破坏具有概念上的重要性时，腕掌比可被视为一种补充方法。
