正畸治疗难度结果需要指数有效性研究.docVIP

正畸治疗难度结果需要指数有效性研究 　　[摘要]目的:检验ICON指数在评价治疗难度、结果和改善程度部分的有效性。方法:哈尔滨医科大学口腔医院10位不同职称的正畸医师对100对按条件选取的治疗前后的模型进行治疗难度、结果和改善程度的评价,测量者再用ICON指数计分这100对模型。在一个月后,专家和测量者再重新测量随机选取的其中的40对模型,运用相关性分析,简单kappa检验和加权kappa检验方法来评价各组内和组间的一致性。结果:专家之间在治疗难度方面的一致性较好(k=0.61),结果方面一致性一般(k=0.32),改善程度方面的一致性较差(k=0.18);ICON测量者对治疗前、后模型测量的的可信度分别为k=0.87,k=0.82。专家组与ICON测量者间难度部分(k=0.67)的一致性为较好,结果部分(k=0.23)的一致性为一般,改善程度部分的一致性为中度(k=0.48)。结论:ICON指数的难度和治疗结果部分是有效的,而在改善程度部分由于专家组间的一致性不好,需进一步被检验。 　　[关键词]正畸治疗难度、结果、需要指数;牙合指数;有效性,错牙合畸形 　　[中图分类号]R783.5 [文献标识码]A [文章编号]1008-6455(2010)03-0392-03 　　 　　Validation of the complexity,treatment outcome and degree of improvement of the index of complexity,outcome and treatment need(ICON) 　　MA Sheng-nan,SHAO Ping,Zhang Miao-miao 　　(Department of Orthodontics,Stomatology School of Harbin Medical University,Harbin 150001,Heilongjiang,China) 　　 　　Abstract:ObjectiveThe purpose of this study was to test the validity of the ICON in measuring orthodontic complexity,outcome,and degree of improvement.MethodsTen orthodontists from harbin medical university evaluated 100 pairs of pretreatment and posttreatment study models for complexity,outcome,and degree of improvement.A calibrated examiner used ICON to score the casts.One month later,a random subset of 40 study casts was recorded by raters and the examiner for reliability testing.A simple kappa statistic was used to assess agreement between the scores from the expert panel and form the ICON examiner. ResultsIterrater agreement was substantial for complexity(k=0.61),slight for outcome(k=0.32),and poor for degree of improvement(k=0.18).Reliability of the calibrated examiner was k=0.87 for pretreatment and k=0.82 for posttreatment casts.Agreement between the raters and the ICON scores was substantial for complexity(k=0.67)and slight for outcome (k=0.23)and moderate for degree of improvement(k=0.27).Conclusion ICON is valid for assessing casts for complexity and outcome.However,lack of agreement among the raters for degree of improvem