[洛杉矶分类在侵蚀性食道炎中的使用:观察者间和观察者内部协议的分析]
Anahí Ayelén de Los Rios1, Juan Ignacio Olmos1, José María Sanguinetti1
1Hospital de Clínicas José de San Martín. Ciudad Autónoma de Buenos Aires, Argentina. Hospital de Clínicas José de San Martín Hospital de Clínicas José de San Martín Ciudad Autónoma de Buenos Aires Argentina.
Acta gastroenterologica Latinoamericana
|March 9, 2026
概括
洛杉矶侵蚀性食道炎的分类显示,医生,特别是住院医生之间的一致性很低. 开发本地协议可以提高胃食道逆流疾病的诊断一致性.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 医学诊断 医学诊断 医学诊断
背景情况:
- 胃食道逆流性疾病 (GERD) 是很常见的,影响10-20%的西方人口.
- 洛杉矶分类是通过内镜对侵蚀性食道炎进行分级的标准.
研究的目的:
- 为了评估医生们对使用洛杉矶分类来分类侵蚀性食道炎的共识.
- 评估住院医生和胃肠病专家之间的不同意见.
主要方法:
- 与59名参与者进行的横截面研究 (34名住院医生,25名专家).
- 参与者使用洛杉矶分类来对40张内镜图像进行分类.
- 与弗莱斯公司 (Fleiss's kappa) 分析了观察者间协议;与科恩公司 (Cohen's kappa) 分析了观察者内部协议.
主要成果:
- 专家之间适度的观察者间一致 (κ=0.425) 和居民之间可以接受的 (κ=0.297).
- 从统计学上看,专家和住院医生之间一致意见的差异显著 (p < 0.001).
- 总体而言,观察者内部的协议是温和的 (κ=0.525).
结论:
- 洛杉矶分类表明食道炎的观察者间和观察者内部一致性很低.
- 经验水平显著影响分类协议.
- 建议制定地方临床内镜协议以进行标准化和培训.
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