GATA脊柱结核分型的可信度与可重复性研究

Reliability and inter-observer reproducibility of GATA classification for spinal tuberculosis

中文关键词:  GATA脊柱结核分型  可信度  可重复性

英文关键词:GATA classification for spinal tuberculosis  Reliability  Reproducibility

中文摘要:

  【摘要】 目的：对GATA脊柱结核分型的可信度及可重复性进行分析，为临床应用提供参考。方法：让4名脊柱外科医师以GATA脊柱结核分型为标准独立对100例脊柱结核患者进行两次分型（间隔１个月），通过计算两两医师之间及同一医师前后两次分型对最后分型、各指标判断相同的平均百分比，确定分型一致性，应用Kappa值和Spearman系数判定其可信度和可重复性，当Kappa值>0.5时有中度或中度以上的一致性，Spearman相关系数值>0.40时有中度或中度以上正性相关。结果：4名医师对各指标（椎体塌陷、椎旁脓肿、脊柱稳定性、脊柱后凸畸形、矢状面指数、椎间盘破坏）及最后分型判断相同的平均百分比分别为61.92%、91.83%、63.33%、60.08%、78.25%、82.00%、52.33%；可信度的Kappa值分别为0.430、0.519、0.317、0.38０、0.536、0.531、0.343；Spearman相关系数分别为 0.392、0.526、0.392、0.503、0.569、0.582、0.576。同一医师前后两次对各指标（椎体塌陷、椎旁脓肿、脊柱稳定性、脊柱后凸畸形、矢状面指数、椎间盘破坏）及最后分型判断相同的平均百分比分别为72.75%、91.00%、85.25%、70.75%、88.75%、81.75%、73.00%；可重复性的Kappa值分别为0.574、0.453、0.627、0.523、0.724、0.584、0.591；Spearman相关系数分别为0.748、0.473、0.632、0.660、0.730、0.613、0.762。结论：GATA脊柱结核分型具有较高的可重复性，但可信度较差。

英文摘要:

  【Abstract】 Objective：To determine the reliability and reproducibility of GATA classification for spinal tuberculosis.Method：A total of 100 cases with spinal tuberculosis were distributed to 4 attending spine surgeons. All surgeons received files including clinical/radiographic data，and an evaluating sheet in terms of GATA classification system.The results were determined by calculating the average percentage of intra-observer and inter-observer agreement to induce the last classifications and the indicators.Reliability and reproducibility were quantified using Kappa coefficients and Spearman rank-order correlation.Moderate consistency was defined as a Kappa value greater than 0.5，moderate positive correlation was defined as Spearman correlation greater than 0.4.Result：Inter-reliability assessed by mean percentage and Kappa coefficiency was 61.92%，0.43 respectively for vertebral collapse，91.83%，0.519 respectively for abscess formation，63.3%，0.317 respectively for instability，60.08%，0.381 respectively for kyphosis，78.25%，0.536 respectively for sagital index，82%，0.531 respectively for disc degeneration，52.33%，0.343 respectively for classification standard.Respective results using Spearman correlation were 0.392，0.526，0.392，0.503，0.569，0.582，and 0.576.Intra-rater mean percentage and Kappa coefficiency were 72.75%，0.574 for vertebral collapse，91%，0.453 for abscess formation，85.25%，0.627 for instability，70.75%，0.523 for kyphosis，88.75%，0.724 for sagital index，81.75%，0.584 for disc degeneration，and 73%，0.591 for classification standard.Respective results using Spearman correlation were 0.748，0.473，0.632，0.66，0.730，0.613，and 0.762.Conclusion：The GATA classification for spinal tuberculosis has good inter-observer reproducibility and low intra-observer reliability.