How reliable is the clinical exam in detecting ocular chlamydial infection?
How reliable is the clinical exam in detecting ocular chlamydial infection?
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DOI：
10.1080/09286580490514577
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发表时间：
2004-07-01
影响因子：
1.8
通讯作者：
Lietman, T
中科院分区：
文献类型：
--
作者：
Miller, K;Schmidt, G;Lietman, T
目的探讨沙眼临床检查与眼衣原体PCR检测的关系。方法对埃塞俄比亚沙眼流行区100名儿童进行3次检测，2次拭子检测，进行PCR分析。比较检测结果，并分析检测结果与PCR结果之间的差异。结果审查员之间的一致性为0.57 (Cohen’s K)， PCR之间的一致性为0.98，审查员与PCR之间的一致性为0.26 ~ 0.34。该检查对感染的阳性预测值为66%。考官之间的差异占考试和PCR之间总方差的30%，其余的可能是由于考试和PCR测量的潜在差异。结论：尽管该检查在年级间的可靠性和与感染证据的相关性不高，但由于其方便和低成本，临床检查被广泛使用。努力使眼科沙眼衣原体的实验室检测更容易负担得起将是有益的。
PURPOSE To describe the relationship between the clinical exam for trachoma and the polymerase chain reaction (PCR) for ocular chlamydia.METHODS One hundred children in a trachoma-endemic area of Ethiopia were examined three times and swabbed twice for PCR analysis. The assays were compared, and an analysis of the variance between exam and PCR was performed.RESULTS Inter-examiner agreement was 0.57 (Cohen's K), inter-PCR agreement 0.98, and agreement between examiner and PCR, 0.26-0.34. The positive predictive value of the exam in identifying infection was 66%. Inter-examiner variance accounted for 30% of the total variance between the exam and PCR, with the remainder presumably due to an underlying difference in what the exam and PCR measure.CONCLUSIONS Despite modest inter-grader reliability and correlation with evidence of infection, the clinical exam is widely used due to its convenience and low cost. Efforts to make laboratory tests for ocular Chlamydia trachomatis more affordable would be useful.