CAJ | 학술논문

目的：比较House-brackmann分级（HBGS)和面神经分级2.0（FNGS 2.0）对周围性面神经麻痹的评价效果。方法3名高年资医师和3名低年资医师分别使用HBGS和FNGS2.0分级方法，对50项周围性面神经麻痹患者的表情视频进行评价。对两种分级方法的重复性、一致性进行分析、比较。结果使用HBGS，低年资医生之间的评价一致性为39.5%，kappa值为0.30，高年资医生之间的评价一致性为56.5%，kappa值为0.43，两组之间具有显著性差异（p<0.05)；使用FNGS2.0，低年资医生间的评价一致性为62.0%，平均ICC值为0.763，高年资医师之间的评价一致性为62.8%，平均ICC值为0.785，两组之间均没有显著性差异（P>0.05)；HBGS和FNGS2.0的总体相关性ICC值为0.760， SCC值为0.746，kappa值为0.42；FNGS2.0与口的相关性为71%。结论 HBGS与FNGS2.0中度相关；使用HBGS，评判者间的一致性受医生的经验水平影响很大，而使用FNGS2.0，评判者重复性和一致性较好，与评判者的经验无关，与口的运动有较强的相关性。
목적：비교House-brackmann분급（HBGS)화면신경분급2.0（FNGS 2.0）대주위성면신경마비적평개효과。방법3명고년자의사화3명저년자의사분별사용HBGS화FNGS2.0분급방법，대50항주위성면신경마비환자적표정시빈진행평개。대량충분급방법적중복성、일치성진행분석、비교。결과사용HBGS，저년자의생지간적평개일치성위39.5%，kappa치위0.30，고년자의생지간적평개일치성위56.5%，kappa치위0.43，량조지간구유현저성차이（p<0.05)；사용FNGS2.0，저년자의생간적평개일치성위62.0%，평균ICC치위0.763，고년자의사지간적평개일치성위62.8%，평균ICC치위0.785，량조지간균몰유현저성차이（P>0.05)；HBGS화FNGS2.0적총체상관성ICC치위0.760， SCC치위0.746，kappa치위0.42；FNGS2.0여구적상관성위71%。결론 HBGS여FNGS2.0중도상관；사용HBGS，평판자간적일치성수의생적경험수평영향흔대，이사용FNGS2.0，평판자중복성화일치성교호，여평판자적경험무관，여구적운동유교강적상관성。
Objectives To analysis the correlation between House-brackmann Grading System (HBGS)and Facial Nerve Grading System2.0 (FNGS2.0) in evaluation of facial nerve paralysis. Methods Fifty video-recorded facial palsy pa-tients were graded by 3 residents and 3 experts using HBGS and FNGS2.0. Results Agreement percentage between residents for HBGS was 39.5%, and generalized kappa indicated only fair agreement(k=0.30);Agreement percentage between experts for HBGS was 56.5%, and generalized kappa indicated moderate agreement(k=0.43);The difference between the observer groups was statistically significant (P<0.05);.Agreement percentage between residents for FNGS2.0 was 62%, and average ICC indicated excellent agreement(ICC=0.763);Agreement percentage between experts for HBGS was 62.8%, and average ICC indicated excel-lent agreement(ICC=0.785);The difference between the observer groups was not statistically significant (P>0.05);The overall intra-class correlation coefficient (ICC) was 0.760,the Spearman correlation coefficient (SCC) was 0.746 and kappa coefficient was 0.42 (P<0.05);The exact agreements between regional assessment and FNGS 2.0 , were highest for the mouth (71%). Conclusions FNGS 2.0 shows moderate agreement with HBGS. For HBGS the interobserver agreement was influnced by the doctor’s experi-ence;For FNGS2.0, the intraobserver and interobserver agreement was high, with no relation to doctor’s experience.