摘要
目的:研究正畸医师对正畸疗效满意度主观评价的一致性情况及其影响因素。方法:从北京大学口腔医学院正畸科2004年7月至2008年8月之间治疗完成的、具有完整临床资料的806个病例中,以安氏分类作为分层因素,随机抽取48个病例,将其治疗后模型、头颅侧位片和面像作为实验材料,进行随机临床试验。仍以安氏分类作为分层因素,将48个病例随机分为4组,请12位正畸专家依据所给治疗后的各项临床资料或者多项资料的组合,对每组12个病例依据治疗结果满意度高低进行排序判断。结果:本试验共得到Spearman相关系数1 584对,Spearman相关系数平均值为0.565 3±0.239 9。不同组别的疗效评价一致性差异有统计学意义(P<0.05)。评价治疗后模型和头颅侧位片时,医师的一致性最高(P<0.001),其余5项实验项目之间差异无统计学意义(P>0.05)。在评价疗效满意度较好和较差的样本时,医师之间的一致性明显高于疗效满意度中等组(P<0.05)。疗程在2.5年以上的样本得分的一致性高于疗程介于1.5年至2.5年之间的样本(P<0.05)。不同安氏分类、不同年龄段和拔牙或不拔牙的样本得分的一致性差异无统计学意义(P>0.05)。结论:医师之间对正畸疗效满意度主观评价呈现中度的一致性,各项因素中,样本的组别、实验项目、疗效满意度水平和疗程是影响医师主观评价一致性的主要因素,样本的安氏分类、年龄和是否拔牙对医师主观评价的一致性无统计学影响。
Objective： To investigate the agreement of subjective evaluation of orthodontic treatment outcome and to analyze possible factors that may be related to it.Methods： As a randomized clinical trial,with Angle＇s classification as a stratification factor,our study contained 48 cases with integrity data,which were randomly extracted from 806 orthodontic treatment cases in Peking University School and Hospital of Stomatology during July 2004 and August 2008,and gathered post-treatment study casts,cephalometrics and photographs of the 48 cases as the research subjects.Similarly with Angle＇s classification as a stratification factor,the 48 cases were randomly divided into 4 groups.According to the monomial and combined subjects,12 clinicians were asked to act as the raters to rank the 12 cases in each group.Results： Overall,there were 1 584 pairings between the raters in the examination of evaluation.The mean Spearman r was 0.565 3±0.239 9.Grouping factor was related to the agreement of subjective evaluation（P0.05）.In the third trial item-Post-M＋P,the correlations were the greatest among the judge-pairs（P0.001）.The other five items were at the same agreement level.The level of orthodontic treatment outcome was a factor that influenced the agreement level of subjective evaluation（P0.05）.The score stability of the patients,whose treatment duration was longer than 2.5 years,was significantly higher than that of the patients whose treatment duration was between 1.5 years and 2.5 years（P0.05）.The following factors,such as Angle＇s classification,age of patients and whether the teeth was extracted or not,were the insignificant factors（P0.05）.Conclusion： The average correlations present a moderate agreement level.Grouping,experimental item,the length of treatment duration and the level of orthodontic treatment outcome are the factors that affect the agreement of subjective evaluation.Several factors including Angle＇s classification,age of patients and whether the teeth is extracted or not,do not affect the agreement of subjective evaluation.
出处
《北京大学学报（医学版）》
CAS
CSCD
北大核心
2012年第1期103-107,共5页
Journal of Peking University:Health Sciences
基金
卫生公益性行业科研专项(200802056)资助~~
关键词
正畸学
治疗结果
统计学
医师
Orthodontics
Treatment outcome
Statistics
Physicians
