Multirater agreement of arthroscopic meniscal lesions
Multirater agreement of arthroscopic meniscal lesions
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DOI：
10.1177/0363546504264586
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发表时间：
2004-12-01
影响因子：
4.8
通讯作者：
Spindler, KP
中科院分区：
文献类型：
--
作者：
Dunn, WR;Wolf, BR;Spindler, KP
背景：建立分类方案的有效性是多中心研究之前的关键准备步骤。有没有研究调查的再现性关节镜下分类的关节炎病理学之间的多名外科医生在不同institutions.Hypothesis：关节镜下分类的关节炎病理学是可靠的和可重复的，适用于多中心的研究，涉及多名surgics.Study Design：Multilater agreement study.Methods：七名外科医生审查了一个视频的18个关节炎撕裂，并完成了关节炎分类问卷。根据一致性比例、kappa系数和组内相关系数计算多评定者一致性。撕裂的中心/外周位置有46%的一致性（kappa = 0.30），撕裂深度的一致率为80%（kappa = 0.46），72%的一致性认为存在退行性部件（kappa = 0.44），71%的一致率关于外侧撕裂是否位于腘裂孔中心（kappa = 0.42），撕裂类型的一致性为73%（kappa = 0.63），撕裂位置的一致性为87%（kappa = 0.61），撕裂治疗的一致性为84%（kappa = 0.66）。结论：关节镜下关节病变分级是可靠的，可重复性好。临床意义：外科医生可以可靠地对关节病变进行分类，并就治疗方案达成一致，这对多中心临床试验非常重要。
Background: Establishing the validity of classification schemes is a crucial preparatory step that should precede multicenter studies. There are no studies investigating the reproducibility of arthroscopic classification of meniscal pathology among multiple surgeons at different institutions.Hypothesis: Arthroscopic classification of meniscal pathology is reliable and reproducible and suitable for multicenter studies that involve multiple surgeons.Study Design: Multirater agreement study.Methods: Seven surgeons reviewed a video of 18 meniscal tears and completed a meniscal classification questionnaire. Multirater agreement was calculated based on the proportion of agreement, the kappa coefficient, and the intraclass correlation coefficient.Results: There was a 46% agreement on the central/peripheral location of tears (kappa = 0.30), an 80% agreement on the depth of tears (kappa = 0.46), a 72% agreement on the presence of a degenerative component (kappa = 0.44), a 71% agreement on whether lateral tears were central to the popliteal hiatus (kappa = 0.42), a 73% agreement on the type of tear (kappa = 0.63), an 87% agreement on the location of the tear (kappa = 0.61), and an 84% agreement on the treatment of tears (kappa = 0.66). There was considerable agreement among surgeons on length, with an intraclass correlation coefficient of 0.78, 95% confidence interval of 0.57 to 0.92, and P < .001.Conclusions: Arthroscopic grading of meniscal pathology is reliable and reproducible.Clinical Relevance: Surgeons can reliably classify meniscal pathology and agree on treatment, which is important for multicenter trials.