Measurement Reliability for Keratitis Morphology.
Measurement Reliability for Keratitis Morphology.
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DOI：
10.1097/ico.0000000000002470
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发表时间：
2020-12
期刊：
影响因子：
2.8
通讯作者：
Woodward MA
中科院分区：
文献类型：
--
作者：
Kriegel MF;Loo J;Farsiu S;Prajna V;Tuohy M;Kim KH;Valicevic AN;Niziol LM;Tan H;Ashfaq HA;Ballouz D;Woodward MA
评价在裂隙灯摄影（SLP）图像上量化角膜解剖学和微生物角膜炎（MK）形态学特征时手动注释的可靠性。普罗维登斯招募的MK患者在两家学术眼科医院首次就诊时接受了SLP。出现上皮缺损（艾德）的患者有资格进行分析。由两位医生在SLP图像上独立注释特征，包括上皮缺损（艾德）、角膜利姆布斯（L）、瞳孔（P）、基质浸润（SI）、SI边缘处的白色血细胞浸润（WBC）和前房积脓（H）。组内相关（ICC）用于可靠性评估;骰子相似系数（DSC）用于调查读者之间的区域重叠。75名患有艾德的MK患者接受了SLP。DSC表明分级者之间（L=0.97，P=0.80，艾德=0.94，SI=0.82，H=0.82，WBC=0.83）和同一分级者重复注释之间（L=0.97，P=0.81，艾德=0.94，SI=0.85，H=0.84，WBC=0.82）的注释重叠为良好至一般。ICC评分显示出良好的分级器间（L=0.98，P=0.78，艾德=1.00，SI=0.67，H=0.97，WBC=0.86）和分级器内（L=0.99，P=0.92，艾德=0.99，SI=0.94，H=0.99，WBC=0.92）可靠性。当对注释的SI区域重新计算可靠性统计时，在两名分级者均认为存在/不存在WBC浸润的病例子集中，分级者ICC改善至0.91，DSC改善至0.86，分级者ICC保持不变，而DSC改善至0.87。手动注释表明面积定量在MK评价中的有用性。然而，可变性是任务所固有的。因此，需要优化注释方案。未来的发展方向可能包括每个图像使用多个注释器或自动注释软件。
To evaluate the reliability of manual annotation when quantifying cornea anatomical and microbial keratitis (MK) morphological features on slit lamp photography (SLP) images. Prospectively enrolled patients with MK underwent SLP at initial encounter at two academic eye hospitals. Patients who presented with an epithelial defect (ED) were eligible for analysis. Features, which included epithelial defect (ED), corneal limbus (L), pupil (P), stromal infiltrate (SI), white blood cell infiltration at the SI edge (WBC), and hypopyon (H), were annotated independently by two physicians on SLP images. Intraclass correlation (ICC) was applied for reliability assessment; Dice Similarity Coefficients (DSC) were used to investigate the area overlap between readers. 75 MK patients with an ED received SLP. DSCs indicate good to fair annotation overlap between graders (L=0.97, P=0.80, ED=0.94, SI=0.82, H=0.82, WBC=0.83) and between repeat annotations by the same grader (L=0.97, P=0.81, ED=0.94, SI=0.85, H=0.84, WBC=0.82). ICC scores showed good intergrader (L=0.98, P=0.78, ED=1.00, SI=0.67, H=0.97, WBC=0.86) and intragrader (L=0.99, P=0.92, ED=0.99, SI=0.94, H=0.99, WBC=0.92) reliabilities. When reliability statistics were recalculated for annotated SI area, in the subset of cases where both graders agreed WBC infiltration was present/absent, intergrader ICC improved to 0.91 and DSC improved to 0.86, and intragrader ICC remained the same while DSC improved to 0.87. Manual annotation indicates usefulness of area quantification in the evaluation of MK. However, variability is intrinsic to the task. Thus, there is a need for optimization of annotation protocols. Future directions may include using multiple annotators per image or automated annotation software.