Inter-observer variation in the results of the clinical andrological examination including estimation of testicular size
Inter-observer variation in the results of the clinical andrological examination including estimation of testicular size
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DOI：
10.1046/j.1365-2605.2000.00240.x
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发表时间：
2000-08-01
影响因子：
--
通讯作者：
Giwercman, A
中科院分区：
文献类型：
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作者：
Carlsen, E;Andersen, AG;Giwercman, A
来自5个北欧和波罗的海国家的10名临床研究者对男科检查的观察者间差异进行了研究。此外，10名研究者中有6名获得了观察者内变异的信息。睾丸大小用普拉德睾丸测量仪测量，其中一名研究者还进行了睾丸大小的超声估计。在估计23名年轻男性的睾丸大小时，观察者之间存在高度显着差异（p < 0.001），观察者间误差为16%。估计值的差异往往随着睾丸大小的增加而增加。在连续几天进行的两次测量中，观察者内无显著差异。只有睾丸大小中位数的差异大于31%，在5%的水平上才有意义。睾丸大小的超声估计值显著低于睾丸体积计估计值，左侧睾丸的平均差异为3.6 mL，右侧睾丸为4.3 mL。生殖器的坦纳分期和精索静脉曲张的诊断在观察者之间存在很大的差异，对于精索静脉曲张的诊断，只有三分之一的研究者能够在第二次检查中重现他们的结果。总之，我们发现年轻男性的临床男科检查在观察者之间存在很大的差异。在比较不同研究的结果时以及在日常临床实践中应记住这一点。
Inter-observer variation in andrological examination by 10 clinical investigators from five Nordic and Baltic countries was investigated. In addition, information on intra-observer variation was obtained for six of the 10 investigators. Testicular size was measured using Prader's orchidometer and one of the investigators also performed an ultrasound estimate of testicular size. A highly significant difference (p < 0.001) between observers was found with an inter-observer error of 16% in estimating testicular size in 23 young men. The difference in the estimate tended to increase with increasing testicular size. There was no significant intra-observer difference in two measurements performed on consecutive days. Only differences in median testis size, which were greater than 31% between measurements by two investigators, were found to be significant at the 5% level. The ultrasound estimate of testicular size was significantly lower than the orchidometer estimate, with a mean difference of 3.6 mL for the left testis and 4.3 mL for the right testis. Tanner staging of genitalia and diagnosis of a varicocele was subject to great inter-observer variation, and for the diagnosis of varicocele only one-third of the investigators was able to reproduce their results on a second examination.In conclusion, it was found that the clinical andrological examination of young men is subject to great inter-observer variation. This should be kept in mind when results from different studies are compared as well as in daily clinical practice.