Grader agreement, and sensitivity and specificity of digital photography in a community optometry-based diabetic eye screening program

Luckni Sellahewa,1,2 Craig Simpson,2 Prema Maharajan,2 John Duffy,2 Iskandar Idris3 1Diabetic Medicine Department, Nottingham University Hospitals, 2North Nottinghamshire Eye Screening Service, Sherwood Forest Hospitals Foundation Trust, 3Division of Medical Sciences and Graduate Entry Medicine, S...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Sellahewa L, Simpson C, Maharajan P, Duffy J, Idris I
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/c5c51faee41c4ae1bd8742769f2cac04
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:c5c51faee41c4ae1bd8742769f2cac04
record_format	dspace
spelling	oai:doaj.org-article:c5c51faee41c4ae1bd8742769f2cac042021-12-02T07:47:08ZGrader agreement, and sensitivity and specificity of digital photography in a community optometry-based diabetic eye screening program1177-5483https://doaj.org/article/c5c51faee41c4ae1bd8742769f2cac042014-07-01T00:00:00Zhttp://www.dovepress.com/grader-agreement-and-sensitivity-and-specificity-of-digital-photograph-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483 Luckni Sellahewa,1,2 Craig Simpson,2 Prema Maharajan,2 John Duffy,2 Iskandar Idris3 1Diabetic Medicine Department, Nottingham University Hospitals, 2North Nottinghamshire Eye Screening Service, Sherwood Forest Hospitals Foundation Trust, 3Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, University of Nottingham, Nottingham, UK Background: Digital retinal photography with mydriasis is the preferred modality for diabetes eye screening. The purpose of this study was to evaluate agreement in grading levels between primary and secondary graders and to calculate their sensitivity and specificity for identifying sight-threatening disease in an optometry-based retinopathy screening program.Methods: This was a retrospective study using data from 8,977 patients registered in the North Nottinghamshire retinal screening program. In all cases, the ophthalmology diagnosis was used as the arbitrator and considered to be the gold standard. Kappa statistics were used to evaluate the level of agreement between graders.Results: Agreement between primary and secondary graders was 51.4% and 79.7% for detecting no retinopathy (R0) and background retinopathy (R1), respectively. For preproliferative (R2) and proliferative retinopathy (R3) at primary grading, agreement between the primary and secondary grader was 100%. Where there was disagreement between the primary and secondary grader for R1, only 2.6% (n=41) were upgraded by an ophthalmologist. The sensitivity and specificity for detecting R3 was 78.2% and 98.1%, respectively. None of the patients upgraded from any level of retinopathy to R3 required photocoagulation therapy. The observed kappa between the primary and secondary grader was 0.3223 (95% confidence interval 0.2937–0.3509), ie, fair agreement, and between the primary grader and ophthalmology for R3 was 0.5667 (95% confidence interval 0.4557–0.6123), ie, moderate agreement. Conclusion: These data provide information on the safety of a community optometry-based retinal screening program for screening as a primary and as a secondary grader. The level of agreement between the primary and secondary grader at a higher level of retinopathy (R2 and R3) was 100%. Sensitivity and specificity for R3 were 78.2% and 98.1%, respectively. None of the false-negative results required photocoagulation therapy. Keywords: retinopathy, screening, public health, community, optometry, diabetesSellahewa LSimpson CMaharajan PDuffy JIdris IDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2014, Iss default, Pp 1345-1349 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Sellahewa L Simpson C Maharajan P Duffy J Idris I Grader agreement, and sensitivity and specificity of digital photography in a community optometry-based diabetic eye screening program
description	Luckni Sellahewa,1,2 Craig Simpson,2 Prema Maharajan,2 John Duffy,2 Iskandar Idris3 1Diabetic Medicine Department, Nottingham University Hospitals, 2North Nottinghamshire Eye Screening Service, Sherwood Forest Hospitals Foundation Trust, 3Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, University of Nottingham, Nottingham, UK Background: Digital retinal photography with mydriasis is the preferred modality for diabetes eye screening. The purpose of this study was to evaluate agreement in grading levels between primary and secondary graders and to calculate their sensitivity and specificity for identifying sight-threatening disease in an optometry-based retinopathy screening program.Methods: This was a retrospective study using data from 8,977 patients registered in the North Nottinghamshire retinal screening program. In all cases, the ophthalmology diagnosis was used as the arbitrator and considered to be the gold standard. Kappa statistics were used to evaluate the level of agreement between graders.Results: Agreement between primary and secondary graders was 51.4% and 79.7% for detecting no retinopathy (R0) and background retinopathy (R1), respectively. For preproliferative (R2) and proliferative retinopathy (R3) at primary grading, agreement between the primary and secondary grader was 100%. Where there was disagreement between the primary and secondary grader for R1, only 2.6% (n=41) were upgraded by an ophthalmologist. The sensitivity and specificity for detecting R3 was 78.2% and 98.1%, respectively. None of the patients upgraded from any level of retinopathy to R3 required photocoagulation therapy. The observed kappa between the primary and secondary grader was 0.3223 (95% confidence interval 0.2937–0.3509), ie, fair agreement, and between the primary grader and ophthalmology for R3 was 0.5667 (95% confidence interval 0.4557–0.6123), ie, moderate agreement. Conclusion: These data provide information on the safety of a community optometry-based retinal screening program for screening as a primary and as a secondary grader. The level of agreement between the primary and secondary grader at a higher level of retinopathy (R2 and R3) was 100%. Sensitivity and specificity for R3 were 78.2% and 98.1%, respectively. None of the false-negative results required photocoagulation therapy. Keywords: retinopathy, screening, public health, community, optometry, diabetes
format	article
author	Sellahewa L Simpson C Maharajan P Duffy J Idris I
author_facet	Sellahewa L Simpson C Maharajan P Duffy J Idris I
author_sort	Sellahewa L
title	Grader agreement, and sensitivity and specificity of digital photography in a community optometry-based diabetic eye screening program
title_short	Grader agreement, and sensitivity and specificity of digital photography in a community optometry-based diabetic eye screening program
title_full	Grader agreement, and sensitivity and specificity of digital photography in a community optometry-based diabetic eye screening program
title_fullStr	Grader agreement, and sensitivity and specificity of digital photography in a community optometry-based diabetic eye screening program
title_full_unstemmed	Grader agreement, and sensitivity and specificity of digital photography in a community optometry-based diabetic eye screening program
title_sort	grader agreement, and sensitivity and specificity of digital photography in a community optometry-based diabetic eye screening program
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/c5c51faee41c4ae1bd8742769f2cac04
work_keys_str_mv	AT sellahewal graderagreementandsensitivityandspecificityofdigitalphotographyinacommunityoptometrybaseddiabeticeyescreeningprogram AT simpsonc graderagreementandsensitivityandspecificityofdigitalphotographyinacommunityoptometrybaseddiabeticeyescreeningprogram AT maharajanp graderagreementandsensitivityandspecificityofdigitalphotographyinacommunityoptometrybaseddiabeticeyescreeningprogram AT duffyj graderagreementandsensitivityandspecificityofdigitalphotographyinacommunityoptometrybaseddiabeticeyescreeningprogram AT idrisi graderagreementandsensitivityandspecificityofdigitalphotographyinacommunityoptometrybaseddiabeticeyescreeningprogram
_version_	1718399183911649280

Grader agreement, and sensitivity and specificity of digital photography in a community optometry-based diabetic eye screening program

Ejemplares similares