帕克兰尺度的观察者间变化. 我们看到了同样的东西吗?
José L Maldonado-Calderón1, Lydia E Nava-Rivera2, Antonio Urbina-Zeglen1
1Departamento de Cirugía, Hospital General Universitario Dr. Joaquín Del Valle Sánchez, Facultad de Medicina, Universidad Autónoma de Coahuila (UAdeC), Torreón, Coahuila.
Cirugia y cirujanos
|November 26, 2024
概括
帕克兰急性胆囊炎分级表 (PGS-AC) 显示外科医生一致意见较低,这表明在诊断急性胆囊炎方面存在显著的观察者间变化. 经验水平影响了诊断的一致性.
科学领域:
- 手术诊断手术诊断手术诊断手术诊断手术诊断手术诊断
- 医学成像分析分析 医学成像分析
- 临床评估工具 临床评估工具
背景情况:
- 急性胆囊炎需要准确的分级才能进行适当的治疗.
- 帕克兰急性胆囊炎分级表 (PGS-AC) 用于分类疾病的严重程度.
- 评估诊断工具的可靠性对于持续的患者护理至关重要.
研究的目的:
- 评估急性胆囊炎 (PGS-AC) 帕克兰分级尺度的观察者间可靠性.
- 用PGS-AC.AC.识别影响外科医生之间协议的因素.
主要方法:
- 对43张腹腔镜胆囊切除术 (LC) 图像的分析.
- 在线问卷分发给18名外科医生和住院医生,用于PGS-AC分类.
- 使用Fleiss κ测试进行评估的观察者间协议.
主要成果:
- 全球Fleiss' κ值为0.213,表明观察者之间的一致性很低.
- 外科住院医生显示出更大的诊断协议.
- 经验超过10年的外科医生或每周进行>2次LC的外科医生具有更高的一致性.
结论:
- 帕克兰急性胆囊炎分级表 (PGS-AC) 显示可靠性低,观察者之间的差异很大.
- 诊断的一致性受到外科医生的经验和实践量的影响.
- 对于客观的PGS-AC应用,可能需要进一步的细化或替代方法.
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