Resnick M I, Smith J A, Scardino P T, Egger M J, Hernandez A, Rose S C
Department of Urology, Case Western Reserve University, Cleveland, Ohio, USA.
J Urol. 1997 Sep;158(3 Pt 1):856-60.
The current study was designed to compare the interpretation of the individual performing transrectal ultrasound examination (operator) with experienced individuals who interpreted the examination with and without the availability of clinical data. Inter-observer and intra-observer variability was compared to determine the reproducibility and reliability of the study.
All patients undergoing radical prostatectomy for treatment of localized carcinoma of the prostate underwent a transrectal ultrasound examination before the procedure. The sonogram was interpreted by the operator and reviewers. The radical prostatectomy specimen was examined pathologically and the staging as determined by ultrasound was compared with the pathological findings.
Ultrasound operator accuracy for extracapsular extension and seminal vesicle invasion was 0.70 and 0.74, respectively, compared with the accuracy of the reviewers, which ranged from 0.59 to 0.75 and 0.44 to 0.74 for extracapsular extension and seminal vesicle invasion, respectively. In general, blinded reviews were less accurate than unblinded reviews but this was only statistically significant for 2 reviewers.
Although for most reviewers the addition of clinical data did not improve the accuracy of the interpretation, an advantage was noted for the operator, that is, the individual performing the examination. In general, the technical quality of the examination was related to the accuracy of the readings.
本研究旨在比较经直肠超声检查者（操作者）与有经验的人员对检查结果的解读，后者解读时分别有和没有临床数据可用。比较观察者间和观察者内的变异性，以确定研究的可重复性和可靠性。
所有因局限性前列腺癌接受根治性前列腺切除术的患者在手术前均接受了经直肠超声检查。超声图像由操作者和审阅者解读。对根治性前列腺切除标本进行病理检查，并将超声确定的分期与病理结果进行比较。
超声操作者对包膜外扩展和精囊侵犯的准确率分别为0.70和0.74，而审阅者的准确率分别为0.59至0.75和0.44至0.74。一般来说，盲法审阅不如非盲法审阅准确，但这仅在2名审阅者中具有统计学意义。
尽管对大多数审阅者而言，增加临床数据并未提高解读的准确性，但对于操作者（即进行检查的个人）而言存在优势。一般来说，检查的技术质量与读数的准确性相关。
