A Standardized Grading System for Scleritis

作者：Sen H Nida^*; Sangave Amit A; Goldstein Debra A; Suhler Eric B; Cunningham Denise; Vitale Susan; Nussenblatt Robert B

来源：Ophthalmology, 2011, 118(4): 768-771.

DOI：10.1016/j.ophtha.2010.08.027

Objective: This study evaluated the performance of a standardized grading system for scleritis using standard digital photographs.
Design: Cross-sectional interobserver agreement study.
Participants: Photo archives from the National Eye Institute.
Methods: Three uveitis specialists from 3 different centers graded 79 randomly arranged images of the sclera with various degrees of inflammation. Grading was done using standard screen resolution (1024x768 pixels) on a 0 to 4+ scale in 2 sessions: (1) without using reference photographs and (2) with reference to a set of standard photographs (proposed grading system). The graders were masked to the order of images, and the order of images was randomized. Interobserver agreement in grading the severity of inflammation with and without the use of grading system was evaluated.
Main Outcome Measures: Interobserver agreement.
Results: The proposed grading system for assessing activity in scleritis demonstrated a good interobserver agreement. Interobserver agreement (pooled kappa) was poor (0.289) without photographic guidance and improved substantially when the "grading system" with standardized photographs was used (kappa = 0.603).
Conclusions: This system of standardized images for scleritis grading provides significantly more consistent grading of scleral inflammation in this study and has clear applications in clinical settings and clinical research.
Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references.

• 出版日期2011-4