应用Bland-Altman分析评价波前像差仪验光与医学验光的一致性  

Evaluation of consistency between wavefront aberration analyzer and medical optometry using Bland-Altman analysis

作　　者：肖信[1] 刘伟民[1] 王英[1] 赵武校[1] 

机构地区：[1]广西壮族自治区人民医院视光科,广西视光中心,广西南宁市530021

出　　处：《眼科新进展》2010年第10期952-954,957,共4页Recent Advances in Ophthalmology

基　　金：广西卫生厅自筹科研课题基金资助(编号:Z2006164)~~

摘　　要：目的探讨Bland-Altman分析在评价波前像差仪验光与医学验光一致性的应用。方法收集在广西视光中心就诊的近视患者136例(267眼),采用WaveScan波前像差仪和医学验光测定患者的球镜、柱镜及等效球镜度数。应用配对t检验和Bland-Altman分析评价2种验光方法的临床一致性。结果经配对t检验,波前像差仪验光与医学验光的球镜、柱镜和等效球镜差异均有统计学意义(均为P<0.05);Bland-Altman分析表明:波前像差仪验光所测的球镜高于医学验光,4.5%的点在95%的一致性界限以外,一致性界限范围内波前像差仪验光与医学验光的柱镜差值的最大绝对值为1.49D,高于临床球镜误差的可接受范围-0.50～+0.75D;波前像差仪验光所测的柱镜高于医学验光,4.5%的点在95%的一致性界限外,在一致性界限范围内波前像差仪验光与医学验光的球镜差值的最大绝对值为0.74D,在临床柱镜误差的可接受范围-0.50～+0.75D内;等效球镜结果显示4.5%的点在95%的一致性界限以外;一致性界限内波前像差仪验光与医学验光的等效球镜差值的最大绝对值为1.54D,高于临床等效球镜误差的可接受范围-1.00～+1.00D。配对t检验和Bland-Altman分析所测球镜和等效球镜的一致性欠佳,所测柱镜的一致性较好。结论相比配对t检验,Bland-Altman分析能给出更合理的结果,是一种理想的一致性评价方法。Objective To investigate the application of Bland-Altman analysis for evaluation of consistency between the wavefront aberration analyzer and medical optometry.Methods Wavefront aberration analyzer and medical optometry were used to measure the sphere,cylinder and spherical equivalent（SE）in 267 eyes of 136 myopic patients,which were randomly selected from the Visual Science and Optometry Center of Guangxi.The clinical consistency of two refractive methods was respectively evaluated by Bland-Altman analysis and paired-samples t test.Results The paired-samples t test showed that sphere,cylinder and SE of two refractive methods had statistical differences（all P0.05）;However,Bland-Altman analysis revealed that the degree of sphere measured by wavefront aberration analyzer was higher than medical optometry,4.5% of the points were beyond the 95% limits of agreement,the maximum absolute value of the sphere difference（1.49 D）was higher than the acceptable range of clinical spherical error（-0.50 to ＋0.75 D）;The degree of cylinder measured by wavefront aberration analyzer was higher than medical optometry,4.5% of the points were beyond the 95% limits of agreement,the maximum absolute value of the cylinder difference（0.74 D）was in the acceptable range of clinical spherical error（-0.50 to ＋0.75 D）;The degree of SE measured by wavefront aberration analyzer was higher than medical optometry,4.5% of the points were beyond the 95% limits of agreement,the maximum absolute value of the SE difference（1.54 D）was higher than the acceptable range of clinical spherical error（-1.00 D to ＋1.00 D）.The consistency of sphere and SE were poor between Bland-Altman analysis and paired-samples t test,but the consistency was great for cylinder.Conclusion Compared with the paired-samples t test,Bland-Altman analysis can give more satisfactory result,so it is a perfect method for evaluation of consistency.

关 键 词：Bland-Altman分析 波前像差 医学验光 一致性 

分 类 号：R778.1[医药卫生—眼科]