CAJ | 학술논문

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。
목적：평개불동훈련수평적의사대특발성척주측철PUMC분형가신도적영향。방법：3명구유불동특발성척주측철진치경험적의사대80례특발성척주측철환자적술전참립위전척주정、측위화앙와위Bending상진행량차측량병분형，량차간격2주。계산평균백분비학정분형일치솔，응용Kappa치판정가신도。결과：PUMC분형적3대형관찰자자신전후일치성화관찰자지간일치성겁가。 PUMC분형적13개아형，3명관찰자자신전후일치성화관찰자지간일치성균위량호도겁가。관찰자1자신전후분형일치성최차（Kappa치위0．738），관찰자2기차（Kappa치위0．770），관찰자3최호（Kappa치위0．903）。관찰자지간일치성결과제시관찰자2 vs 3일치성최호（Kappa치위0．770）；관찰자1 vs 2화관찰자1 vs 3분형일치성결과접근（Kappa치분별위0．739화0．737）。결론：PUMC삼대형이급아형적분형일치성균교호，의사훈련수평재일정정도상영향PUMC분형적일치성。
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 per-formed 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 interob-server 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 .