Concordancia interobservador en la detección de bocio por palpación en población escolar / Interobserver agreement in detecting goitre by palpation in a school population

Objetivo: Estimar la concordancia interobservador en la detección de bocio por exploración física en población escolar. Metodología: Se realizó un estudio transversal para la detección de bocio en una muestra representativa de 1.134 escolares de 6 a 12 años de 20 colegios del área de salud de La Mancha Centro. La exploración fue realizada de forma enmascarada por 2 únicos observadores. Se establecieron 5 grados de tamaño tiroideo (0, I a, I b, II y III ). Se consideró bocio a partir del grado i a. La concordancia se valoró en relación con variables como edad, sexo, índice de masa corporal, talla y día de exploración. Se utilizó el índice kappa como medida de concordancia. Resultados: En los 1.097 escolares con doble exploración, en 96 (8,8%) se detectó bocio por el observador 1 y en 102 (9,3%) por el 2 (p = 0,58). El grado de acuerdo interobservador en la identificación y en la graduación del bocio fue moderado (kappa 0,55; IC del 95%, 0,46-0,64) para la primera y sustancial (kappa ponderado 0,61; IC del 95%, 0,51-0,71) para la segunda. Fue algo mayor en las niñas y en los escolares de mayor edad, peso, talla e índice de masa corporal. La concordancia entre observadores fue relativamente estable a lo largo de la realización del estudio. Conclusiones: La concordancia interobservador en la detección de bocio por palpación en nuestro estudio es moderada, aunque más baja en los niños más pequeños e invariable durante todo el periodo en el que se realizó (AU)

Objective: To estimate the agreement between observers on the detection of goitre by physical exploration in a school population. Methodology: We performed a cross-sectional study to detect goitre in a representative sample of 1134 schoolchildren aged 6 to 12 years from 20 schools in the health area of La Mancha Centro. The examination was performed blinded by two observers. Five grades in thyroid size were established (0, Ia, Ib, II and III ). Above grade Ia was considered as goitre. The agreement was assessed in relation to variables such as age, sex, body mass index, height, and day of examination. The weighted kappa was used to measure the agreement. Results: In the 1097 schoolchildren with a dual examination, 96 (8.8%) cases of goitre were detected by observer 1, and 102 (9.3%) cases by observer 2, (P=0.58). The degree of interobserver agreement in the identification and grading of goitre was moderate (kappa 0,55, 95%CI: 0,46 to 0,64) for the first, and substantial (weighted kappa 0,61; 95% CI: 0,51 to 0,71) for the second. The degree of agreement was somewhat higher in girls, older schoolchildren, increased weight, height, and body mass index. The interobserver agreement was relatively stable throughout the study. Conclusions: The interobserver agreement in detecting goitre by palpation in our study is moderate, but is lower in younger children and stable for the duration of study (AU)

[Interobserver agreement in detecting goitre by palpation in a school population]. / Concordancia interobservador en la detección de bocio por palpación en población escolar.

OBJECTIVE: To estimate the agreement between observers on the detection of goitre by physical exploration in a school population. METHODOLOGY: We performed a cross-sectional study to detect goitre in a representative sample of 1134 schoolchildren aged 6 to 12 years from 20 schools in the health area of La Mancha Centro. The examination was performed blinded by two observers. Five grades in thyroid size were established (0, Ia, Ib, II and III). Above grade Ia was considered as goitre. The agreement was assessed in relation to variables such as age, sex, body mass index, height, and day of examination. The weighted kappa was used to measure the agreement. RESULTS: In the 1097 schoolchildren with a dual examination, 96 (8.8%) cases of goitre were detected by observer 1, and 102 (9.3%) cases by observer 2, (P=.58). The degree of interobserver agreement in the identification and grading of goitre was moderate (kappa 0,55, 95%CI: 0,46 to 0,64) for the first, and substantial (weighted kappa 0,61; 95%CI: 0,51 to 0,71) for the second. The degree of agreement was somewhat higher in girls, older schoolchildren, increased weight, height, and body mass index. The interobserver agreement was relatively stable throughout the study. CONCLUSIONS: The interobserver agreement in detecting goitre by palpation in our study is moderate, but is lower in younger children and stable for the duration of study.