设为首页 | 加入收藏
| 欢迎光临本站!

消化内镜学分会官方网站

当前位置:文献追踪 > 国内外期刊

超声內镜成像诊断胰腺囊肿的操作者一致性研究

发布日期:2014-1-29 12:40:10 文章来源:Endoscopy 作者次数:1217
    超声內镜成像诊断胰腺囊肿的操作者一致性研究
    K.  de Jong1, T.  Verlaan1, M.  G.  Dijkgraaf2, J.  W.  Poley3, H.  van Dullemen4, M.  J.  Bruno3, P.  Fockens1
    2荷兰阿姆斯特丹大学学术医疗中心生物统计和临床流行病系
    3 荷兰鹿特丹大学医学中心,伊拉斯姆斯医学中心胃肠病学和肝病学部门 
    4荷兰格罗宁根大学医学中心胃肠病学和肝病学系
     
    背景与研究目的:
    超声内镜成像是一种很有价值的评估胰腺囊肿技术。现在这个研究的目的是评定三组不同操作者对于超声内镜检查胰腺囊肿特征的一致性。
    患者与方法:
    为了检测胰腺囊肿,准备40个超声内镜成像程序的视频序列,三组操作者分别有不同水平的超声内镜检查经验:1组由具有丰富超声內镜检查经验的四位专家组成,2组由超声内镜检查经验不足的四位“半-专家”组成,3组由没超声内镜检查经验的四位非专业住院医师组成。记分点包括隔膜,结节,结块,胰腺管通道。规定这个推定诊断以组内相关系数(ICC)划分一致性等级,优秀(> 0.80),良好(0.61 - 0.80),中等(0.41 - 0.60),不错(0.20 - 0.40),差(<0.20)。
     
    结果:
    判断结节的一致性结果:专家组为良(ICC 0.65),半-专家和新手组均为不错(ICC分别为 0.32 ,0.37);相比其它两组(半-专家为0.09,新手0.03)专家组对于是否存在结块,有显著高的一致性(ICC 0.52);关于明确诊断一致性,专家组等级为中等(0.43),半-专家组为差(0.09),新手为不差(0.30)
    结论:
    在超声内镜检查经验方面具有专家级别的操作者,他们组对胰腺囊肿特征判断一致性大部分属于中等,等于或高于半-专家组和新手组。
     
    Original article
    Endoscopy 2011; 43(7): 579-584
    DOI: 10.1055/s-0030-1256434

    © Georg Thieme Verlag KG Stuttgart · New York
     
     
    Interobserver agreement for endosonography in the diagnosis of pancreatic cysts
     
    K.  de Jong1, T.  Verlaan1, M.  G.  Dijkgraaf2, J.  W.  Poley3, H.  van Dullemen4, M.  J.  Bruno3, P.  Fockens1
    1 Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
    2 Department of Biostatistics and Clinical Epidemiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
    3 Department of Gastroenterology and Hepatology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands
    4 Department of Gastroenterology and Hepatology, University Medical Center Groningen, The Netherlands

    Background and study aims: Endosonography is considered a valuable technique in the evaluation of pancreatic cysts. The aim of the present study is to assess interobserver agreement, in three different observer groups, regarding EUS for characterization of pancreatic cysts.

    Patients and methods: Video sequences of 40 EUS procedures for pancreatic cysts were prepared. Three groups of observers had different levels of EUS experience: group 1 comprised four experts with extensive EUS experience, group 2 had four “semi-experts” with limited EUS experience, and group 3 (novices) comprised four non-expert resident physicians without EUS experience. Features scored included septations, nodules, solid components, and pancreatic duct communication. A presumptive diagnosis had to be specified. The intraclass correlation coefficient (ICC) was used, with agreement classed as excellent (> 0.80), good (0.61 - 0.80), moderate (0.41 - 0.60), fair (0.20 - 0.40), and poor (< 0.20).

    Results: Agreement regarding nodules was good among experts (ICC 0.65) and fair in the semi-expert and novice groups (ICC 0.32 and 0.37, respectively). For presence of solid components there was significantly higher agreement among experts (ICC 0.52) compared with the other two groups (semi-experts 0.09, and novices 0.03). Agreement regarding specific diagnosis was moderate in the expert group (0.43), poor among the semi-experts (0.09), and fair among the novices (0.30).

    Conclusions: Interobserver agreement among expert endosonographers was mostly moderate for characteristics of pancreatic cysts. However, interobserver agreement for experts was equal to or higher than that in the semi-expert and in the novice groups.

    (作者:)
相关评论
用户名: 登录