An alternative method of grading diabetic retinopathy.
An alternative method of grading diabetic retinopathy.
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DOI：
10.1016/s0161-6420(86)33606-6
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发表时间：
1986-09
期刊：
影响因子：
13.7
通讯作者：
R. Klein;B. E. Klein;Y. Magli;Rosemary J. Brothers;S. Meuer;S. Moss;Matthew D. Davis
中科院分区：
文献类型：
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作者：
R. Klein;B. E. Klein;Y. Magli;Rosemary J. Brothers;S. Meuer;S. Moss;Matthew D. Davis
本报告的目的是 (1) 提出一种对糖尿病视网膜病变严重程度进行分级的系统，该系统是一种快速、相对便宜且标准化的替代方案，可替代更详细的早期治疗糖尿病视网膜病变研究 (ETDRS) 系统； (2) 提供其再现性的数据； (3) 将其与详细的 ETDRS 分级系统进行比较。替代系统用于对大型患病率研究（威斯康星州糖尿病视网膜病变流行病学研究 (WESDR)）中获得的眼底照片进行分级。替代方法包括对七个立体标准视野进行整体分级，并使用改进的艾尔利屋分类方案根据视网膜病变的最大程度分配眼睛的严重程度。使用视网膜病变严重程度递增的八级分类系统，替代方法与 ETDRS 系统之间的精确一致性为 78.3%。评分者对所有 503 项分歧进行了重新评分，49.3% 的人与替代系统完全一致，35.7% 的人与详细系统完全一致，15.0% 的人既不与替代系统也不与详细系统完全一致。替代系统的观察者间一致性为 78.5%； 9 个月至 1 年期间观察者内部的一致性对于 1 级学生为 90.0%，对于 2 级学生为 84.0%。当经验丰富的分级员使用时，替代分级系统是一种在流行病学研究中客观确定视网膜病变状态的可重复方法。
The purpose of this report is to (1) present a system for grading the severity of diabetic retinopathy that is a rapid, relatively inexpensive, and standardized alternative to the more detailed Early Treatment Diabetic Retinopathy Study (ETDRS) system; (2) present data on its reproducibility; and (3) compare it to the detailed ETDRS grading system. The alternative system was used to grade fundus photographs obtained during a large prevalence study, the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR). The alternative method involved grading seven stereoscopic standard fields as a whole, and assigning a level of severity for the eye according to the greatest degree of retinopathy using a modified Airlie House Classification scheme.Using an eight-level classification system of increasing severity of retinopathy, there was 78.3% exact agreement between the alternative and ETDRS systems. A grader regraded all 503 disagreements, and was in exact agreement 49.3% of the time with the alternative system, 35.7% of the time with the detailed system, and 15.0% with neither the alternative or detailed systems. Interobserver agreement for the alternative system was 78.5%; intraobserver agreement over a 9 month to 1 year period was 90.0% for grader 1 and 84.0% for grader 2. The alternative system of grading, when used by experienced graders, is a reproducible method for objectively determining retinopathy status in epidemiologic studies.