Prospective reliability analysis.
Nine patients with a spectrum of clinical features of TED were assessed by 6 experienced observers on the same day. Agreement among the observers was analyzed using the Krippendorff alpha.
The Krippendorff alpha for the total CAS was 0.532 (95% CI = 0.199-0.665), whereas alpha values for the individual components of the CAS varied between 0.171 (CI = 0.000-0.334) for lid redness and 0.671 (CI = 0.294-1.000) for spontaneous pain. Assuming that a CAS value ≥3 implies suitability of the patient for anti-inflammatory treatment, the calculated Krippendorff alpha for agreement among assessors on whether treatment should be given or not given was 0.332 (95% CI = 0.0011-0.5862).
This study has shown unreliable inter-observer variability in total CAS and most individual CAS components, thus highlighting the need for improving the performance of the CAS or seeking other methods to assess activity.
方法:前瞻性信度分析。
方法:在同一天由6名经验丰富的观察者评估了9名具有一系列TED临床特征的患者。使用Krippendorffalpha分析了观察者之间的协议。
结果:总CAS的Krippendorffα为0.532(95%CI=0.199-0.665),而CAS各组分的α值在眼睑发红的0.171(CI=0.000-0.334)和自发性疼痛的0.671(CI=0.294-1.000)之间变化。假设CAS值≥3意味着患者适合抗炎治疗,评估人员对是否应给予治疗的一致性计算的Krippendorffα为0.332(95%CI=0.0011~0.5862).
结论:这项研究表明,在总CAS和大多数单独CAS成分中,观察者之间的差异不可靠,因此强调需要提高CAS的绩效或寻求其他方法来评估活动。