摘要目的:评价不同训练水平的医师对特发性脊柱侧凸PUMC分型可信度的影响。方法:3名具有不同特发性脊柱侧凸诊治经验的医师对80例特发性脊柱侧凸患者的术前站立位全脊柱正、侧位和仰卧位Bending像进行两次测量并分型，两次间隔2周。计算平均百分比确定分型一致率，应用Kappa值判定可信度。结果:PUMC分型的3大型观察者自身前后一致性和观察者之间一致性极佳。PUMC分型的13个亚型，3名观察者自身前后一致性和观察者之间一致性均为良好到极佳。观察者1自身前后分型一致性最差 (Kappa值为0.738)，观察者2其次 (Kappa值为0.770)，观察者3最好 (Kappa值为0.903)。观察者之间一致性结果提示观察者2 vs 3一致性最好 (Kappa值为0.770)；观察者1 vs 2和观察者1 vs 3分型一致性结果接近 (Kappa值分别为0.739和0.737)。结论:PUMC三大型以及亚型的分型一致性均较好，医师训练水平在一定程度上影响PUMC分型的一致性。
Abstract：Objective:To determine whether the level of professional training would affect reliability of PUMC classification for adolescent idiopathic scoliosis. Methods:Examinations of preoperative radiographs (standing full-length posteroanterior, lateral and two supine side-bending radiographs) of 80 cases were performed by 3 orthopedic surgeons with a completely different degree of professional training according to PUMC’s criteria twice at the interval of two weeks. Kappa statistics were used to determine intraobserver and interobserver agreement.Results:The PUMC type demonstrated excellent intraobserver and interobserver reliability. While the subtype demonstrated good to excellent intraobserver and interobserver agreement. Among them, the intraobserver agreement for Observer 1 was the lowest with kappa coefficients of 0.738, while the intraobserver agreement for Observer 3 was the highest with kappa coefficients of 0.903. The intraobserver agreement was middle with kappa coefficients of 0.770. A maximum kappa coefficient of 0.770 for the pair of Observer 2 and Observer 3 was determined and 0.739 and 0.737 for the other two pairs of observers were shown.Conclusions:The results confirm that both PUMC type and subtype have a good reliability. The degree of professional training seems to influence the reliability of PUMC classification.
王宇仁，王晖，蒋盛旦，郑新峰，盛伟斌，陈晓东，蒋雷生. 医师训练水平对青少年特发性脊柱侧凸PUMC分型可信度的影响[J]. 中华解剖与临床杂志, 2013, 18(5): 406-408.
WANG Yu-ren,WANG Hui,JIANG Sheng-dan,ZHENG Xin-feng,SHENG Wei-bin,CHEN Xiao-dong,JIANG Lei-sheng. Level of Professional Training for Interobserver and Intraobserver Agreement of PUMC Classifications for Idiopathic Scoliosis. Chinese Journal of Anatomy and Clinics, 2013, 18(5): 406-408.
2013, Vol. 18 
