Labrecque M, Dostaler L P, Dumont H, Huard G, Laflamme L
Département de médecine familiale, Université Laval, Sainte-Foy, Qué.
CMAJ. 1993 Feb 15;148(4):559-64.
To determine the interobserver reliability of tympanograms obtained with the MicroTymp, a portable tympanometer. SETTING: Family medicine teaching unit in a tertiary care hospital. PATIENTS: Thirty-three patients who presented to the ear, nose and throat clinic in August 1990 for an ear problem. INTERVENTION: Three residents in family medicine independently attempted to record with the MicroTymp one tympanogram for the 66 ears. We excluded the results for seven ears for which tympanograms could not be obtained. MAIN OUTCOME MEASURE: Using objective criteria, two family physicians and two residents in family medicine independently classified the 177 tympanograms into five categories (normal, possible effusion, possible perforation, possible tympano-ossicular dysfunction and unclassifiable). Reliability was estimated by means of the kappa (kappa) coefficient on 161 tympanograms from 59 ears for which the interpretation of the three tympanograms agreed. MAIN RESULTS: The interpretation of the three tympanograms agreed for 34 of the 59 ears (0.58) (kappa = 0.52, 95% confidence limits 0.45 and 0.59). There was no significant difference in interobserver reliability between pairs of observers or between symptomatic and asymptomatic ears. CONCLUSIONS: The interobserver reliability of the MicroTymp is moderate. The tympanograms obtained with the instrument should be interpreted in the context of the clinical findings.
确定使用便携式鼓室图仪MicroTymp获得的鼓室图的观察者间可靠性。
一家三级护理医院的家庭医学教学单位。
1990年8月因耳部问题就诊于耳鼻喉科门诊的33名患者。
三名家庭医学住院医师独立尝试使用MicroTymp为66只耳朵记录一张鼓室图。我们排除了7只无法获得鼓室图的耳朵的结果。
两名家庭医生和两名家庭医学住院医师根据客观标准将177张鼓室图独立分为五类(正常、可能有积液、可能有穿孔、可能有鼓室-听骨链功能障碍和无法分类)。通过kappa(κ)系数对来自59只耳朵的161张鼓室图的可靠性进行评估,这59只耳朵的三张鼓室图的解读是一致的。
59只耳朵中的34只(0.58)的三张鼓室图解读一致(κ = 0.52,95%置信区间0.45和0.59)。观察者对之间或有症状和无症状耳朵之间的观察者间可靠性没有显著差异。
MicroTymp的观察者间可靠性为中等。使用该仪器获得的鼓室图应结合临床发现进行解读。