Intraobserver and interobserver agreement in measurement of optic disc characteristics.

Intraobserver and interobserver agreement in measurement of optic disc characteristics.
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观察者内和观察者间在视盘特征测量方面的一致性。

DOI:
10.1016/s0161-6420(88)33177-5
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发表时间:
1988
期刊:
影响因子:
13.7
通讯作者:
Sommer,A
Sommer,A
中科院分区:
医学1区
文献类型:
--
作者:
Tielsch,JM;Katz,J;Quigley,HA;Miller,NR;Sommer,A

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可靠的视神经状态测量是青光眼流行病学和临床研究的重要参数。立体眼底照相已被用来减少观察者间的差异,但很少有数据报道量化这些情况下的一致性水平。这篇文章检查了水平和垂直视杯的机会校正的观察者内和观察者间的一致性:立体、彩色、眼底照片上最窄的剩余神经视网膜边缘的视盘比率和宽度。观察者内部的一致性对于两位读者来说都是实质性的甚至几乎完美的(水平和垂直杯盘比的Kappas在0.82到0.86之间,神经视网膜边缘的Kappas在0.71之间)。观察者之间的一致性也很高(水平杯盘比的Kappas为0.71,垂直杯盘比的Kappas为0.74,神经视网膜边缘的Kappas为0.58)。观察者内和观察者间的一致性对于青光眼患者最好,其次是眼部高血压患者和对照组。使用一系列截断点(≥0.5、≥0.6和≥0.7盘直径[DD])将盘:可疑或不可疑的盘比率划分为可疑盘数和不可疑盘数对一致性水平几乎没有影响。对视神经状态的估计是复杂的,需要对杯子的形状和结构进行判断。通过使用立体照片,使用相同的观察者,并在评估进展时,比较一次会议上不同时间点的照片,来优化一致性。
Reliable measures of optic nerve status are important parameters for epidemiologic and clinical studies of glaucoma. Stereo fundus photography has been used to reduce Interobserver variation, but little data have been reported quantifying the level of agreement in these situations. This article examines chance-corrected Intraobserver and Interobserver agreement for horizontal and vertical cup:disc ratios and width of the narrowest remaining neuroretinal rim on stereo, color, fundus photographs. Intraobserver agreement was substantial to almost perfect for both readers (kappas between 0.82 and 0.86 for horizontal and vertical cup:disc ratios and 0.71 for the neuroretinal rim). Interobserver agreement was also substantial (kappas of 0.71 for horizontal cup:disc ratio, 0.74 for vertical cup:disc ratio, and 0.58 for the neuroretinal rim). Both Intraobserver and Interobserver agreement were best for glaucoma patients followed by ocular hypertensives and controls. Dichotimizing cup:disc ratios into suspicious or not suspicious using a range of cutoff points (≥0.5, ≥0.6, and ≥0.7 disc diameters [DD]) had little effect on agreement levels. Estimation of the status of the optic nerve is complex, requiring judgment about the shape and structure of the cup. Agreement is optimized by using stereo photographs, using the same observer and, when evaluating progression, comparing photographs from different points in time at a single sitting.
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