Validation of grading scales for contact lens complications
Validation of grading scales for contact lens complications
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DOI：
10.1046/j.1475-1313.2001.00575.x
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发表时间：
2001-01-01
影响因子：
2.9
通讯作者：
Katsara, SS
中科院分区：
文献类型：
--
作者：
Efron, N;Morgan, PB;Katsara, SS
在精确度和可靠性方面评估了使用两组艺术家渲染和两组摄影分级量表（分级“系统”）的有效性，这些分级量表旨在衡量角膜接触镜相关眼部病理的严重程度。13名观察员分别对所有4种分级系统常见的3种接触透镜并发症（角膜染色、结膜发红和乳头状结膜炎）的30张图像进行分级-通过内插或外推至最接近的0.1增量。大约两周后重复整个过程，产生包括9360个个体分级估计的总数据库。方差分析显示系统、观察者和条件之间的精确度和可靠性存在统计学显著差异（系统可靠性p < 0.03;所有其他组合p = 0.0001）。艺术家呈现的系统通常提供较低的分级估计酸更好的分级可靠性比摄影系统。角膜染色的分级不如结膜发红和乳头状结膜炎可靠。评分的可靠性一般不受被评估疾病的严重程度的影响。尽管存在上述差异，但所有四种分级系统均经临床使用验证，从业者最初可以预期使用这些系统，平均95%置信限为+/-1.2个分级量表单位（观察者范围+/-0.7至+/-2.5个分级量表单位）。鉴于本研究中揭示的系统间显著差异，建议始终使用相同的分级系统。通过应用个性化的校正因子来标准化分级估计值，可能会减少观察者之间的差异。(C)2000年验光师学院。由Elsevier Science Ltd.出版，版权所有。
The validity of use of two artist-rendered and two photographic sets of grading scales (grading 'systems') designed for gauging the severity of contact lens-related ocular pathology was assessed in terms of precision and reliability. Thirteen observers each graded 30 images - by interpolation or extrapolation to the nearest 0.1 increment - of each of the three contact lens complications (corneal staining, conjunctival redness and papillary conjunctivitis) that were common to all four grading systems. This entire procedure was repeated approximately two weeks later, yielding a total data base comprising of 9360 individual grading estimates. Analysis of variance revealed statistically significant differences in both precision and reliability between systems, observers and conditions (p < 0.03 for system reliability; p = 0.0001 for all other combinations). The artist-rendered systems generally afforded lower grading estimates acid better grading reliability than the photographic systems. Corneal staining could be graded less reliably than conjunctival redness and papillary conjunctivitis. Grading reliability was generally unaffected by the severity of the condition being assessed. Notwithstanding the above differences, all four grading systems are validated for clinical use and practitioners can initially expect to use these systems with average 95% confidence limits of +/-1.2 grading scale units (observer range +/-0.7 to +/-2.5 grading scale units). In view of the significant between-system differences revealed in this study, it is advisable to consistently use the same grading system. It may be possible to reduce between-observer differences by applying personalised correction factors to normalise grading estimates. (C) 2000 The College of Optometrists. Published by Elsevier Science Ltd. All rights reserved.