Interrater reliability of assessing levator ani muscle defects with magnetic resonance images
Interrater reliability of assessing levator ani muscle defects with magnetic resonance images
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DOI：
10.1007/s00192-006-0224-5
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发表时间：
2007-07-01
影响因子：
1.8
通讯作者：
DeLancey, John O. L.
中科院分区：
文献类型：
--
作者：
Morgan, Daniel M.;Umek, Wolfgang;DeLancey, John O. L.
本研究的目的是确定评价者间的可靠性评估耻骨内脏提肛肌缺陷的磁共振图像。正常耻骨内脏肌被指定为0级; PVM缺陷被分级为轻度=1（不到一半缺失），中度=2（超过一半缺失），重度=3（完全或接近完全缺失）。在六对检查者中，计算一致性百分比和加权Kappa系数以确定检查者对之间和所有检查者之间的一致性（即，“整体”）。对于单侧评分，准确一致率为83.7%，一级、二级和三级差异分别为14.7%、1.5%和0.1%。对于双侧评分，一级、二级和三级的准确一致率和差异率分别为75.4%、15.9%、6.9%和1.6%。因此，在91.3%的病例中达到了完全一致或1分差异。当缺陷状态被分类为无/正常、轻微和严重时，总体加权kappa系数为0.86（95% CI 0.83，0.89）。单侧（p=0.002）和双侧（p=0.02）评分的检查者对之间存在差异，但当缺陷状态被分类为无/正常、轻微和严重（p=0.59）时则无差异。当6名检查者对肛提肌缺陷进行7分制评分时，91%的病例在1分以内达成一致。当缺陷状态被分类为正常/无、轻微或严重时，检查者对损伤的区分相似。
The objective of this study is to determine interrater reliability of assessing pubovisceral levator ani muscle defects with magnetic resonance images. Normal pubovisceral muscle was assigned a grade of 0; PVM defects were graded as mild=1 (less than half missing), moderate=2 (more than half missing), and severe=3 (total or near total loss). Among six pairs of examiners, percent agreement and weighted kappa coefficients were calculated to determine agreement between pairs of examiners and among all examiners (i.e., "overall"). For unilateral scoring, exact agreement was found in 83.7%, and differences of one, two, and three grades were found in 14.7, 1.5, and 0.1%, respectively. For bilateral scoring, exact agreement and differences of one, two and three grades were found in 75.4, 15.9, 6.9, and 1.6%, respectively. Thus, exact agreement or a one-point difference was reached in 91.3% of cases. When defect status was categorized as none/normal, minor, and major, the overall weighted kappa coefficient was 0.86 (95% CI 0.83, 0.89). There was variation among examiner pairs with unilateral (p=0.002) and bilateral (p=0.02) scoring, but not when defect status was categorized as none/normal, minor, and major (p=0.59). There was agreement to within one point in 91% of cases when six examiner pairs scored levator ani defects on a seven-point scale. Examiner pairs discriminated injury similarly when defect status was categorized as normal/none, minor, or major.