An interrater reliability study of a new 'zonal' classification for reporting the location of retinal haemorrhages in childhood for clinical, legal and research purposes
An interrater reliability study of a new 'zonal' classification for reporting the location of retinal haemorrhages in childhood for clinical, legal and research purposes
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DOI：
10.1136/bjo.2009.162271
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发表时间：
2010-07-01
影响因子：
4.1
通讯作者：
Minns, Robert A.
中科院分区：
文献类型：
--
作者：
Fleck, Brian W.;Tandon, Anamika;Minns, Robert A.
背景/目的为了发展和评估视网膜的带状分类，以便于描述儿童视网膜出血的位置，方法根据视盘和血管弓的解剖标志设计了一种新的视网膜带状分类，通过回顾大量的宽视野数字视网膜图像，这些图像来自我们的儿童数据库，意外头部损伤和其他脑病。四个专家审查员，然后独立地“定位”142视网膜出血区，从31个高质量的photographs.Results科恩的未加权kappa评分为所有可能对四个评级（即6对）范围从0.86到0.92，这是“几乎完美”的协议。Fleiss对多个评分者（四个）和多个类别（三个）之间的一致性的Kappa值为0.8841，这是“几乎完美”的一致性。科恩的未加权kappa统计intrarater可靠性给出了一个整体的一致性，范围从“实质性的”到“完美的”agreement.Conclusion这种新的视网膜区分类和使用的照片和模板是一个非常可靠的工具，报告的位置视网膜出血从多个病因在儿童，并可能是有用的研究和法医报告。
Background/Aims To develop and assess a zonal classification of the retina to facilitate description of the location of retinal haemorrhages in children.Methods A novel zonal classification of the retina was devised based on the anatomical landmarks of the optic disc and vascular arcades, by reviewing a large number of wide field digital retinal images drawn from our database of children with accidental and non-accidental head injury and other encepthalopathies. Four expert examiners then independently 'located' 142 retinal haemorrhages by zone, from 31 high quality photographs.Results Cohen's unweighted kappa scores for all possible pairs of the four raters (ie, six pairs) ranged from 0.86 to 0.92, that is 'almost perfect' agreement. Fleiss' kappa for agreement between multiple raters (four) and for multiple categories (three) was 0.8841, that is 'almost perfect' agreement. Cohen's unweighted kappa statistic for intrarater reliability gave an overall concordance that ranged from 'substantial' to 'perfect' agreement.Conclusion This new retinal zone classification and the use of photographs and templates is a very reliable tool for reporting the location of retinal haemorrhages from multiple aetiologies in children, and may be useful for research and medico-legal reports.