Inter-observer agreement in clinical decision-making for abnormal cardiotocogram during labour: a comparison between CTG and CTG plus STAN.

摘要

There are two main problems with this study.1. The authors use as the denominators for the estimation of the 95% confidence intervals the number of trials of agreement. But these trials of agreement are not independent of one another. It is the number of the subjects that should be the denominator. The correct 95% confidence interval for the overall agreement of car-diotocography (CTG) is 0.78 (0.64, 0.93); and for CTG plus ST waveform analysis (STAN) is 0.83 (0.70, 0.97). With the number of subjects as the denominator, none of the comparisons carried out by the authors reach the conventional level of statistical significance.