Zuna I, Delorme S, Huber S, Danes J, Teubner J, Lorenz A, van Kaick G
Forschungsschwerpunkt, radiologische Diagnostik und Therapie des Deutschen Krebsforschungszentrums (DKFZ), Heidelberg.
Radiologe. 1998 May;38(5):355-63. doi: 10.1007/s001170050365.
This paper demonstrates the statistical processing of data from a multicentric study. Seventy-seven patients with a suspicious, solid breast mass were included in a two-center study, using clinical breast examination, mammography, and ultrasound. The assessment was formalized using a uniform evaluation sheet. The prospective results of the examinations were compared with the histologic report. The degree of interdependence between an examiner's diagnosis and diagnostic criteria used was assessed using the kappa statistics. We found that despite standardized assessment, the criteria used for differential diagnosis were at least partially different. The criteria valid for diagnosis at both centers were whether a mass fitted well into the surrounding tissue or led to destruction or architectural distortion, whether it was fixed to the surrounding tissues, as assessed by sonopalpation maneuvers, and whether it borders were sharp or unsharp.
本文展示了一项多中心研究数据的统计处理。77例有可疑实性乳腺肿块的患者被纳入一项双中心研究，采用临床乳腺检查、乳腺X线摄影和超声检查。评估通过统一的评估表进行规范。将检查的前瞻性结果与组织学报告进行比较。使用kappa统计量评估检查者诊断与所用诊断标准之间的相互依赖程度。我们发现，尽管评估是标准化的，但用于鉴别诊断的标准至少部分存在差异。两个中心均有效的诊断标准是肿块是否与周围组织贴合良好或导致破坏或结构扭曲、通过超声触诊操作评估其是否与周围组织固定以及其边界是否清晰。
