肺部超声波在专家运营商的S:Scoring和Inter-rater可靠性分析 (LESSON研究) 中,第二次COWS研究分析来自ITALUS集团
Enrico Boero1, Luna Gargani2, Annia Schreiber3,4
1Department of Anaesthesia and Intensive Care Unit, San Giovanni Bosco Hospital, Turin, Italy.
Journal of anesthesia, analgesia and critical care
|July 31, 2024
概括
经验丰富的肺超声波 (LUS) 操作员在评分呼吸系统疾病方面表现出高度一致,提高了诊断可靠性. 这证实了LUS是评估疾病严重程度的可靠工具,特别是在先进成像技术有限的地方.
科学领域:
- 医疗成像医学成像
- 肺部病理学 肺部病理学
- 临界护理医学 临界护理医学
背景情况:
- 肺部超声波 (LUS) 是一种非侵入性诊断工具,用于治疗诸如,肺炎和肺胸炎等肺部疾病.
- 在资源有限的环境中,LUS是有价值的,并减少了辐射暴露,使其适合儿科患者.
- 低呼吸率得分量化了区域的通风损失,有助于评估呼吸系统疾病的严重程度,但需要评估其观察者之间的可靠性.
研究的目的:
- 在经验丰富的操作人员中系统评估肺超声波 (LUS) 得分的观察者间可靠性.
- 为了确定LUS视频片段中显示的预定义发现的协议级别.
主要方法:
- 对20名经验丰富的操作人员展示了25个LUS发现的视频片段,这些经验丰富的操作人员对临床数据视而不见.
- 运营商使用在线表格来评估使用五种不同的超声波机获得的剪辑中的LUS分数.
- 弗莱斯-科恩加权的卡帕被用于统计分析评价者之间的协议.
主要成果:
- 评价者之间的一致性很高,弗莱斯的卡帕在0.87 (95% CI 0.815-0.931,p < 0.001).
- 评分0和3显示出较高的可复制性,而评分1和2则显示出较高的可复制性.
- 虽然6个片段完全同意,但大多数有17个或更多的操作员同意乐谱.
结论:
- 经验丰富的肺部超声波操作员之间存在非常高的互评级协议.
- 测量LUS得分的20%宽容度是一个可靠的估计,减少了解释的变化.
- 这些发现支持对LUS用于呼吸系统疾病评估的临床应用的信心增加.
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