视盘立体照片训练前后的评价。

S Callewaert, S Fieuws, I Stalmans, T Zeyen
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引用次数: 0

摘要

目的:探讨非专业眼科医生通过视盘彩色立体照片系列判断青光眼病变的诊断准确性在培训后是否发生变化。方法:在鲁汶大学医院接受培训的24名眼科医生根据连续视盘立体照片的评估,将50只不同严重程度的青光眼分为稳定型和进展型。比较住院医师(n=18)和实习生(n=6)在培训前后的诊断准确性。结果:实习医师培训前与参考标准的平均一致性(kappa)低于住院医师。住院医师训练前平均kappa为0.37,受训人员训练前平均kappa为0.29 (p = 0.18)。培训后与参考标准的平均一致性显著提高(受训人员从0.29提高到0.56 [p = 0.031],住院医师从0.37提高到0.48 [p = 0.005])。总体平均kappa训练前为0.35,训练后为0.50 (p < 0.001)。结论:住院医师接受培训后,对视盘系列照片评价的一致性和诊断准确性均有显著提高。
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Appraisal of optic disc stereo photos pre- and post-training session.

Purpose: To determine whether the diagnostic accuracy of judging serial optic disc color stereo photographs for glaucomatous change by non-expert ophthalmologists changed after a training session.

Methods: 24 ophthalmologists in training at the University Hospitals Leuven classified 50 eyes with varying severity of glaucoma as stable or progressing based on the appraisal of serial optic disc stereo photographs. A comparison between the diagnostic accuracy of residents (n=18) and trainees (n=6) was made before and after a training session.

Results: The mean agreement (kappa) with the reference standard before training was lower for the trainees than for the residents. The mean kappa before training was 0.37 for the residents and 0.29 for the trainees (p = 0.18). The mean agreement with the reference standard improved significantly after a training (from 0.29 to 0.56 [p = 0.031 for the trainees, and from 0.37 to 0.48 for the residents [p = 0.005]). The overall mean kappa was 0.35 pre-training and 0.50 post-training (p < 0.001).

Conclusions: The agreement and diagnostic accuracy of residents in training in appraising serial optic disc photos improved significantly after a training session.

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