在儿童患者的动态灵活支气管透视术使用下呼吸道马拉西亚的诊断中观察者内部和观察者间的一致性
Fazılcan Zirek1, Gizem Özcan2, Merve Nur Tekin1
1Division of Pediatric Pulmonology, Department of Pediatrics, Faculty of Medicine, Ankara University, Ankara, Turkey.
Pediatric pulmonology
|April 21, 2025
概括
通过灵活的支气管镜检查在儿童中诊断下呼吸道疾病 (LAM) 显示了专家之间的中度一致意见. 需要标准化指导方针来提高一致性,以改善儿科患者的治疗结果.
科学领域:
- 儿科肺病学 儿科肺病学
- 呼吸系统医学 呼吸系统医学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 下呼吸道马拉西亚 (LAM) 涉及到过度的呼吸道崩在过期.
- 灵活支气管镜是LAM诊断的标准,但受到观察者之间的变化和技术限制的影响.
- 这项研究评估了儿科患者LAM的诊断一致性.
研究的目的:
- 评估使用动态灵活支气管镜诊断LAM的观察者内部和观察者间的一致性.
- 评估支气管镜尺寸和观察员培训对LAM诊断协议的影响.
主要方法:
- 100个匿名的动态灵活支气管镜视频 (50个LAM,50个正常) 被六名儿科肺病专家审查.
- 使用标准化标准来诊断LAM,包括气管 (TM) 和支气管 (BM).
- 使用科恩的卡帕系数分析了观察者内部和观察者间的一致性.
主要成果:
- 对于LAM诊断的观察者内部一致性是相当大的,几乎是完美的 (0.6750.857).
- 观察者间的一致性是中度至实质性的 (0.5830.689),在使用2.8毫米支气管镜的TM中最高.
- 与多个培训师设置相比,单个培训师的评估观察到更高的观察者间一致性;对于BM,一致性较低.
结论:
- 在LAM诊断的变化需要标准化的指导方针.
- 标准化可以提高诊断准确度,并改善儿科LAM患者的治疗结果.
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