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首页> 外文期刊>Acta Obstetricia et Gynecologica Scandinavica: Official Publication of the Nordisk Forening for Obstetrik och Gynekologi >Inter- and intra-observer agreement of non-reassuring cardiotocography analysis and subsequent clinical management
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Inter- and intra-observer agreement of non-reassuring cardiotocography analysis and subsequent clinical management

机译：观察者之间和观察者内部对不确定性心动描记术分析和后续临床治疗的同意

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Objective To quantify inter- and intra-observer agreement of non-reassuring intrapartum cardiotocography (CTG) patterns and subsequent clinical management. Design Methodological study. Setting University Medical Center. Population CTG patterns of 79 women beyond 37 weeks of gestation with a singleton fetus in vertex position in first stage of labor in whom fetal blood sampling (FBS) had been performed. Methods Nine observers assessed CTG patterns, which were formerly clinically classified as non-reassuring and indicative for FBS, according to the guidelines of the International Federation of Gynecology and Obstetrics modified for ST analysis. They also proposed clinical management strategies without and with insight into clinical parameters. Weighted kappa values (κw) and proportions of agreement (Pa) were calculated. Main outcome measures Agreement on CTG classification and clinical management. Results Inter-observer agreement on CTG classification and on clinical management were poor for most observer categories (κw range 0.31-0.50 and 0.20-0.45, respectively). Observers agreed best on abnormal CTG patterns (Pa range 0.28-0.36) and on the clinical management option "continue monitoring" (Pa range 0.32-0.40). Intra-observer agreement was fair to good for most observers (κw 0.33-0.70). Insight into clinical parameters resulted in similar inter- and intra-observer agreement. Conclusions There was poor inter-observer agreement and fair to good intra-observer agreement on classification and clinical management of intrapartum CTG patterns, which had been classified as non-reassuring and indicative for FBS during birth.
机译：目的量化不安定的产前心电图（CTG）模式和随后的临床治疗的观察者间和观察者内一致性。设计方法论研究。设置大学医学中心。妊娠37周后79名妇女的人口CTG模式，在分娩的第一阶段进行了胎血采样（FBS）的婴儿中，其单胎处于顶点位置。方法9名观察者根据国际妇产科联合会（ST）修改后的指南评估了CTG模式，该模式先前在临床上被归类为不能令人放心的FBS指标。他们还提出了没有临床参数并且不了解临床参数的临床管理策略。计算加权κ值（κw）和一致比例（Pa）。主要结果指标关于CTG分类和临床管理的协议。结果对于大多数观察者类别，观察者之间在CTG分类和临床管理方面的共识很差（κw范围分别为0.31-0.50和0.20-0.45）。观察者对CTG异常模式（Pa范围0.28-0.36）和临床管理选项“持续监测”（Pa范围0.32-0.40）达成了最佳共识。观察者内部的协议对大多数观察者来说是公平的（κw0.33-0.70）。对临床参数的深入了解导致观察者之间和观察者之间达成了相似的协议。结论对于产妇内CTG模式的分类和临床管理，观察者之间的一致性差，观察者内部的一致性差，良好的观察者一致性差，这在出生时被认为是不能令人放心的FBS指标。

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