Is musculoskeletal ultrasonography an operator-dependent method or a fast and reliably teachable diagnostic tool? Interreader agreements of three ultrasonographers with different training levels.
Is musculoskeletal ultrasonography an operator-dependent method or a fast and reliably teachable diagnostic tool? Interreader agreements of three ultrasonographers with different training levels.
复制标题
DOI：
10.1155/2010/164518
复制
发表时间：
2010
影响因子：
2.3
通讯作者：
Backhaus M
中科院分区：
文献类型：
--
作者：
Ohrndorf S;Naumann L;Grundey J;Scheel T;Scheel AK;Werner C;Backhaus M
目标.评估三名（高级、初级和初级）不同经验的肌肉骨骼超声医师之间的阅片者间协议和学习曲线。高级充当成像“金标准”。方法.对15例类风湿关节炎（RA）患者的临床优势关节（指、肩、膝、胫距和距舟）进行了检查，检查者为3名不同经验的超声医师（高10岁，低10个月，初学1个月）。每个患者的超声检查结果报告不知道其他研究者的结果。计算κ系数、一致率、灵敏度和特异性。结果对15例RA患者的120个关节进行了评价。将初级和初级的结果与高级的结果进行比较，初级和初级的所有检查关节的总体κ为0.83（93%），初级为0.43（76%）。关于不同的关节，初级的研究结果与高级的研究结果非常相关（指关节：κ = 0.82;肩关节：κ = 0.9;膝关节：κ = 0.74;胫距关节：κ = 0.84;距舟关节：κ = 0.84）而初学者的发现仅显示出一般至中等的一致性（指关节：κ = 0.4;肩关节：κ = 0.42;膝关节：κ = 0.4;胫距关节：κ = 0.59;距舟关节：κ = 0.35）。总体而言，初学者的结果从基线时的κ = 0.34（一致性67%）明显改善到评估期结束时的κ = 0.78（一致性89%）。结论.一名有10个月经验的研究者与一名资深超声医师的超声评价基本一致。初学者和经验丰富的超声医师之间的协议在开始时是公平的，但在研究期间，包括15例RA患者的超声检查，初学者在肌肉骨骼超声检查方面明显改善。
Objectives. To assess interreader agreements and a learning curve between three (senior, junior, and beginner) different experienced musculoskeletal ultrasonographers. Senior served as the imaging “gold standard”. Methods. Clinically dominant joints (finger, shoulder, knee, tibiotalar, and talonavicular) of 15 rheumatoid arthritis (RA) patients were examined by three different experienced ultrasonographers (senior 10 years, junior 10 months, and beginner one month). Each patient's ultrasonographic findings were reported unaware of the other investigators' results. κ coefficients, percentage agreements, sensitivities, and specificities were calculated. Results. 120 joints of 15 RA patients were evaluated. Comparing junior's and beginner's results each to the senior's findings, the overall κ for all examined joints was 0.83 (93%) for junior and 0.43 (76%) for beginner. Regarding the different joints, junior's findings correlate very well with the senior's findings (finger joints: κ = 0.82; shoulder: κ = 0.9; knee: κ = 0.74; tibiotalar joint: κ = 0.84; talonavicular joint: κ = 0.84) while beginner's findings just showed fair to moderate agreements (finger joints: κ = 0.4; shoulder: κ = 0.42; knee: κ = 0.4; tibiotalar joint: κ = 0.59; talonavicular joint: κ = 0.35). In total, beginner's results clearly improved from κ = 0.34 (agreement of 67%) at baseline to κ = 0.78 (agreement of 89%) at the end of the evaluation period. Conclusions. Ultrasonographic evaluation of a ten-month-experienced investigator in comparison to a senior ultrasonographer was of substantial agreement. Agreements between a beginner and a highly experienced ultrasonographer were only fair at the beginning, but during the study including ultrasonographical sessions of 15 RA patients, the beginner clearly improved in musculoskeletal ultrasonography.