对于外围肺部病变的辐射-内支气管超声波图像解释的观察者间和观察者内部变异性
Nathaniel Moulton1, Mohammed Abbasi2, Danish Ahmad3
1Washington University School of Medicine, St. Louis, MO, USA.
Journal of thoracic disease
|February 27, 2024
概括
实践肺病学家在解释外周肺病变的辐射探头内支气管超声波 (R-EBUS) 图像方面表现出显著的变化. 标准化R-EBUS解释可以提高诊断的一致性和临床应用.
科学领域:
- 肺部病理学 肺部病理学
- 干预性肺病学 干预性肺病学
- 医疗成像医学成像
背景情况:
- 射线探头内支气管超声波 (R-EBUS) 是支气管镜检查期间诊断外周肺病变的关键工具.
- 报告了不一致的诊断产量,可能是由于缺乏标准化的R-EBUS图像解释.
- 损伤度分级的变化可能会影响程序的性能.
研究的目的:
- 评估实践肺病学家在解释R-EBUS图像中的变异性.
- 评估R-EBUS图像表征中的观察者之间的和观察者内部的协议.
主要方法:
- 对10位干预性肺病学家进行了一项调查,他们解释了来自外围支气管透视病例的100张R-EBUS图像.
- 图像在两个时间点 (基线和3个月) 呈现,分为集中,偏心或没有图像.
- 科恩的卡帕系数被用来计算观察者之间的和观察者内部的变化.
主要成果:
- 所有10名参与者都完成了调查,参与率为100%.
- 观察者间的变异性显示了中度的一致性 (两个调查的Kappa统计数据为0.496和0.477).
- 观察者内部变异性显示出强烈的一致性 (两项调查之间的卡帕统计数据为0.803).
结论:
- 肺病学家在表征R-EBUS图像方面存在显著的差异.
- 在两次调查期间,每个参与者都表现出强烈的内定价协议.
- 建议为R-EBUS模式开发一种标准化的方法和分级系统,以提高一致性并优化临床使用和研究.
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