评价乳腺癌严重程度和治疗结果的观察者间和观察者内部协议:主观和客观评估方法的比较
Hendrik van Braak1,2, Sjoerd A de Beer1, Sander Zwaveling1
1Department of Pediatric Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands.
概括
视觉评估乳腺癌 (PC) 严重程度和治疗结果显示观察者之间缺乏一致性. 标准化的3D扫描可以提高PC形的评估一致性.
科学领域:
- 胸部外科手术 胸部外科手术
- 整形外科手术 整形外科手术
- 医学成像医学成像
背景情况:
- 视觉检查对于评估乳腺癌 (PC) 严重程度和治疗疗效至关重要.
- 这项研究调查了治疗前和治疗后PC视觉评估的一致性.
研究的目的:
- 评价观察者之间和观察者内部对乳腺癌治疗的审美结果的共识.
- 在治疗前评估PC严重程度和对称性的协议.
- 为了比较拉维奇手术和动态压缩支架 (DCS支架) 之间的美学结果,并分析痕,年龄和治疗持续时间的影响.
主要方法:
- 对201名患有乳腺癌的患者 (4-18岁) 的医疗照片进行了审查.
- 五位外科医生和五位同行评估了变形的严重程度,对称性和审美结果.
- 使用kappa统计数据 (κ) 计算了观察者间和观察者内部的协议.
主要成果:
- 外科医生和同行都显示出对美学结果 (κ=0.26, κ=0.22),PC严重程度 (κ=0.43, κ=0.38) 和对称性 (κ=0.37) 的不充分的观察者间一致.
- 在审美结果 (κ=0.49, κ=0.34) 和PC严重程度 (κ=0.54, κ=0.48) 上,观察者内部的一致性也不足.
- 拉维奇手术的结果是,尽管最初的严重程度更高,但结果更好;伤对同行产生了负面影响,但对外科医生没有负面影响. 年龄和治疗持续时间与结果没有相关性.
结论:
- 对乳腺癌严重程度和美学结果的主观视觉评估是不一致的.
- 三维扫描为标准化治疗评估提供了一个潜在的方法.
- 痕的心理社会方面应该在治疗规划期间讨论 pectus carinatum.
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