Inter-grader reliability in the Danish screening programme for diabetic retinopathy.

Autor: Thykjaer AS; Department of Ophthalmology, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark., Andresen J; Organization of Danish Practicing Ophthalmologists, Copenhagen, Denmark., Andersen N; Organization of Danish Practicing Ophthalmologists, Copenhagen, Denmark., Bek T; Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark., Heegaard S; Department of Ophthalmology, Rigshospitalet-Glostrup, Copenhagen, Denmark., Hajari J; Department of Ophthalmology, Rigshospitalet-Glostrup, Copenhagen, Denmark., Schmidt Laugesen C; Department of Ophthalmology, Zealand University Hospital Roskilde, Roskilde, Denmark., Möller S; Research Unit OPEN, Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Pedersen FN; Department of Ophthalmology, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Kawasaki R; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; Department of Vision Informatics, University of Osaka, Osaka, Japan., Højlund K; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark., Rubin KH; Research Unit OPEN, Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Stokholm L; Research Unit OPEN, Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Peto T; Centre for Public Health, Queen's University Belfast, Belfast, UK., Grauslund J; Department of Ophthalmology, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.; Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.
Jazyk: angličtina
Zdroj: Acta ophthalmologica [Acta Ophthalmol] 2023 Nov; Vol. 101 (7), pp. 783-788. Date of Electronic Publication: 2023 Apr 17.
DOI: 10.1111/aos.15667
Abstrakt: Purpose: The Danish Registry of Diabetic Retinopathy includes information from >200 000 patients who attends diabetic retinopathy (DR) screening in Denmark. Screening of patients with uncomplicated type 2 diabetes is often performed by practicing ophthalmologists, while patients with type 1 and complicated type 2 diabetes attends screening at hospitals. We performed a clinical reliability study of retinal images from Danish screening facilities to explore the inter-grader agreement between the primary screening ophthalmologist and a blinded, certified grader.
Methods: Invitations to participate were sent to screening facilities across Denmark. The primary grader uploaded fundus photographs with information on estimated level of DR (International Clinical Diabetic Retinopathy scale as 0 [no DR], 1-3 [mild, moderate or severe nonproliferative DR {NPDR}], or 4 [proliferative DR {PDR}]), region of screening, image style, and screening facility. Images were then regraded by a blinded, certified, secondary grader. Weighted kappa analysis was performed to evaluate agreement.
Results: Fundus photographs from 230 patients (458 eyes) were received from practicing ophthalmologists (52.6%) and hospital-based grading centres (47.4%) from all Danish regions. Reported levels of DR by the primary graders were 66.8%, 12.2%, 13.1%, 1.3% and 5.5% for DR levels 0-4. The overall agreement between primary and secondary graders was 93% (κ = 0.83). Based on screening facility agreement was 96% (κ = 0.89) and 90% (κ = 0.76) for practicing ophthalmologists and hospital-based graders.
Conclusion: In this nationwide study, we observed a high overall inter-grader agreement and based on this, it is reasonable to assume that reported DR gradings in the screening programme in Denmark, accurately reflect the truth.
(© 2023 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.)
Databáze: MEDLINE
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