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在英国NHS乳腺查计划中,乳腺扫描读者之间的召回决定的观察者间变异性:观察者间变异性衡量的比较
Laura Quinn1, David Jenkinson2, Sian Taylor-Phillips3
1Department of Applied Health Sciences, University of Birmingham, Birmingham, UK; NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, UK.
European journal of radiology
|February 14, 2026
概括
乳房镜召回决定的观察者间变异性在第一次查时较低,在随后的查时较高. 由于患病率偏差,科恩的卡帕不适合用于低患病率查.
科学领域:
- 放射学和成像学 放射学和成像学
- 生物统计学 生物统计学
- 公共卫生 公共卫生
背景情况:
- 乳房扫描对早期发现乳腺癌至关重要.
- 乳房影像解释的观察者间的变化可能会影响查的有效性.
- 英国国家卫生服务 (NHS) 乳腺查计划旨在标准化查质量.
研究的目的:
- 评估NHS乳腺查计划中乳腺扫描读者的召回决定之间的一致性.
- 为了比较不同统计测量观察者间变异性的表现.
主要方法:
- 分析了22个NHS中心401,682名妇女的数据.
- 两位读者对乳房影像的独立解释.
- 计算和比较百分比一致性,偏差调整后偏差调整后的kappa (PABAK),Gwet的一致系数 (Gwet的AC) 和Cohen的kappa.
- 根据查类型 (第一个与后一个),癌症诊断,读者回忆率和年龄组进行分层分析.
主要成果:
- 较低的协议 (百分比协议,Gwet的AC,PABAK) 在第一次选期间被观察到与随后的选相比.
- 当癌症被检测出来时,以及读者回忆率更高时,协议措施较低.
- 科恩的卡帕显示不一致的模式,严重受到召回的流行影响,使其不适合低流行程度的设置.
结论:
- 百分比协议,Gwet的AC和PABAK是评估乳房镜检查观察者间变异性的更可靠措施.
- 科恩的卡帕不适合低患病率查场景,因为它易受患病率偏差的影响.
- 了解和解决观察者之间的变化对于优化乳腺癌查计划至关重要.
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