Skin thickness score in systemic sclerosis: an assessment of interobserver variability in 3 independent studies.
Skin thickness score in systemic sclerosis: an assessment of interobserver variability in 3 independent studies.
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发表时间：
1993-12
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通讯作者：
P. Clements;P. Lachenbruch;J. Seibold;B. Zee;V. Steen;P. Brennan;A. Silman;N. Allegar;J. Varga;M. Massa
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作者：
P. Clements;P. Lachenbruch;J. Seibold;B. Zee;V. Steen;P. Brennan;A. Silman;N. Allegar;J. Varga;M. Massa
目的：利用3项独立研究的数据，量化用于评估系统性硬化症（SSc）患者皮肤增厚程度和程度的半定量皮肤评分方法（原始和改进的Rodnan皮肤厚度评分）的观察者间可靠性。方法在一项研究中评估原始罗德南皮肤厚度评分法（26个体表区域的皮肤厚度，使用0-4级评分）的观察者间变异性。2项研究评估了改进的Rodnan方法（使用0-3分制评估17个体表区域的皮肤厚度）。在所有3项研究中，每个患者的皮肤厚度由6或7名观察员以盲法评估。结果无论总体平均皮肤厚度评分（26.6、18.3和17.7）如何，所有3项研究的总体患者内标准差（5.4、4.6和4.6）均无统计学差异。采用原始的Rodnan技术，皮肤厚度评分越高的患者，患者内标准差越高。在使用改良技术的两项研究中，高和低皮肤厚度评分之间的患者标准偏差没有显着差异。三个独立的研究表明，Rodnan皮肤厚度评分技术在不同的观察者中是可重复的（患者内标准偏差一致约为5个单位）。我们的数据为SSc试验的样本量计算提供了有价值的信息，其中皮肤厚度评分是一个结果变量。
OBJECTIVE Using data from 3 independent studies, to quantify the interobserver reliability of semi-quantitative skin scoring methods (the original and the modified Rodnan skin thickness scores) used to assess the degree and extent of cutaneous thickening in systemic sclerosis (SSc). METHOD Interobserver variability of the original Rodnan skin thickness score method (cutaneous thickness assessed in 26 body surface areas using a 0-4 scale) was evaluated in one study. The modified Rodnan method (cutaneous thickness assessed in 17 body surface areas using a 0-3 scale) was evaluated in 2 studies. In all 3 studies, each patient's skin thickness was assessed by 6 or 7 observers in a blinded fashion. RESULTS The overall within patient standard deviations were not statistically different in all 3 studies (5.4, 4.6 and 4.6) irrespective of the overall mean skin thickness scores (26.6, 18.3 and 17.7). With the original Rodnan technique, the within patient standard deviation tended to be higher in patients with higher skin thickness scores. In the 2 studies which used the modified technique, no significant differences in within patient standard deviation were noted between high and low skin thickness scores. CONCLUSIONS Three independent studies demonstrate that the Rodnan skin thickness scoring techniques are reproducible among different observers (the within patient standard deviation being consistently about 5 units). Our data provide valuable information needed for sample size calculations for SSc trials in which skin thickness score is an outcome variable.