Taulukossa «Progression arvioinnin yhteneväisyys stereokuvista. Kliinikoiden välinen yhteneväisyys progression arvioinnissa papillakuvista on keskimäärin 72 % (54–92 %). ...»1 on kuvattu viiden vuosina 1989–2002 asiaa selvittäneen tutkimuksen tulokset «Coleman AL, Sommer A, Enger C ym. Interobserver an...»1, «Girkin CA, Emdadi A, Sample PA ym. Short-wavelengt...»2, «Heijl A, Bengtsson B. Diagnosis of early glaucoma ...»3, «Caprioli J, Prum B, Zeyen T. Comparison of methods...»4, «Heijl A, Leske MC, Bengtsson B ym. Reduction of in...»5.
Yhteneväisyys (%) | Kirjallisuusviite | ||||||
---|---|---|---|---|---|---|---|
3 gl. eksperttiä vs | n=19 | 54 | Varhaisia glaukoomia | «Coleman AL, Sommer A, Enger C ym. Interobserver an...»1 | |||
4 oftalmologia | 71 | ||||||
2 arvioijaa | 36 / 47 | 76 | Sairaala-aineisto (glaukoomapotilaita) | «Girkin CA, Emdadi A, Sample PA ym. Short-wavelengt...»2 | |||
2 arvioijaa (+ flicker chronoscopy) | 15 / 22 (68 %) | 68 | RCT (korkean riskin OHT) | «Heijl A, Bengtsson B. Diagnosis of early glaucoma ...»3 | |||
2 arvioijaa | Kappa | kliininen papilla- arvio | papilla- mittaus | hermosäie- kerros | 92 | Sairaala-aineisto (OHT + glakooma) | «Caprioli J, Prum B, Zeyen T. Comparison of methods...»4 |
Intra-observer | 0,81 | 0,75 | 0,76 | ||||
Inter-observer | 0,92 | 0,89 | 0,87 | ||||
Keskiarvo | 72 | ||||||
Kommentti: Kaikissa aiemmin seulottu potilasmateriaali. | |||||||
2 arvioijaa | Kappa | Flicker | 255 | RCT | «Heijl A, Leske MC, Bengtsson B ym. Reduction of in...»5 | ||
Intra-observer | 0,5–0,73 | ||||||
Inter-observer | 0,63 |
Tutkimus
The agreement of flicker chronoscopy for structural glaucomatous progression detection and factors associated with progression was evaluated in a retrospective study «Chee RI, Silva FQ, Ehrlich JR ym. Agreement of fli...»6. Two glaucoma fellowship-trained ophthalmologists, masked to temporal sequence, independently graded serial flicker chronoscopy images from 1 eye of a cohort of glaucoma patients for features of structural progression. Agreement between graders was determined, as was accuracy for determining the temporal order of images. After adjudication, simple and multiple logistic models were constructed to determine baseline variables associated with increased odds of progression.
Fifty of 103 included eyes/patients (49 %) had at least 1 sign of structural progression. Temporal sequence was incorrectly determined in 14 of 206 cases (6.4 %). Interobserver agreements for identifying baseline photographs (κ = 0.9), global progression (κ = 0.7), parapapillary atrophy (PPA) progression (κ = 0.7), disc hemorrhages (κ = 0.7), neuroretinal rim loss (κ = 0.5), and retinal nerve fiber layer (RNFL) loss (κ = 0.2) were calculated. On multivariable analysis, only age was associated with global progression (1.8; 1.2-2.5, P = .002).
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