十位来自五个不同机构的调查者进行睾丸体积测量的组间和组内差异

目的:对多单位男性生殖功能流行病学研究中的睾丸体积测量进行质量控制研究。方法:我们构建了一个平衡分配数据矩阵,由10位来自5个不同研究所的调查者(从事男科学工作4到21年)在连续的两天内用 Prader 睾丸测量器测量12个男性志愿者(20—26岁)的睾丸体积。睾丸体积超声估计由一个经验丰富的技术人员完成。结果:10个调查者测量双侧睾丸体积的结果存在显著的组间统计差异(P<0.05)。睾丸体积测量结果显示调查者和志愿者之间存在显著的统计意义上的相互作用(P<0.01)。但是连续两天通过2种测量方法测得的双侧睾丸体积结果之间无显著差异。用超声波检查法测得的左右睾丸体积小于用睾丸测量器测得的值,但无显著差异(P>0.05)。调查者的工作经验没有显著影响睾丸体积测量结果的精确度。结论:研究表明10个调查者对睾丸体积的估计结果之间有显著差异,但组内差异不明显。因此,有必要在多单位男科学调研之前进行良好的培训和确定适当的测量标准。

Inter/intra investigator variation in orchidometric measure-ments of testicular volume by ten investigators from five insti-tutions

Aim:To perform quality control studies on testicular volume measurements for a multi-center epidemiological study of male reproductive function.Methods:We constructed a data matrix with a balanced assignment for 2 consecutive days by ten investigators(andrological career:4-21 years)from five institutions and 12 male volunteers aged 20-26 years.Testicular volume was measured by Prader's orchidometer.A skilled technician also perfornled an ultrasound estimate of testicular volume.Results:A statistically significant inter-investigator variation was found *'or both testes (P<0.05).In addition,there was a statistically significant investigator-by-volunteer interaction in testicular volume measurement(P<0.01).However,there was no statistically significant difference in the two measurements performed on consecutive days for either testis.The testicular volumes for both the right and left testes as estimated by ultrasonog- raphy were smaller than results using the orchidometer.However,there was no statistical significance(P>0.05).The difference in experiences of the investigators did not significantly correlate with accuracy of measurements in either testis.Conclusion:The present study revealed significant differences in the results of estimation of testicular volume among the ten investigators,but intra-investigator variation was not considerable.Improved training and proper standardization of the measurement will be necessary before starting a multi-center study based on an andrological examination,