Original articleInterobserver Agreement in Grading Activity and Site of Inflammation in Eyes of Patients with Uveitis
Section snippets
Methods
The participating clinicians had at least eight years of experience as attending uveitis subspecialists. One clinician visited the practice of the other three participants to conduct the gradings, yielding three pairs of gradings. In advance of the study, each participant reviewed the SUN grading criteria for locus of inflammation, AC cells and flare, and vitreous cells (present vs absent) and haze. Tables describing the grading criteria were referred to during grading, as was a high-quality
Results
Paired gradings by two observers were performed on 202 eyes of 101 patients. Among these, uveitis was agreed by both graders to be absent in 43 second eyes (42.6% of second eyes). For 15 additional eyes (9.4% of eyes with uveitis), both graders agreed that the site of inflammation could not be determined based on examination, generally because of an opaque cataract.
For grading of AC cells, exact agreement was 57.0%, 51.4%, and 56.9% at the three centers, respectively (Figure 1). The
Discussion
We believe that these data constitute the first formal analysis evaluating the reproducibility of criteria proposed by an international consensus panel for grading the anatomic location of uveitis and its activity in the AC and vitreous cavity. An appropriately large sample of eyes with uveitis was graded at three different centers by uveitis experts who have participated in international clinical trials that use these gradings as study outcomes.
Although exact agreement in grading of AC cells
Dr John H. Kempen is an Associate Professor of Ophthalmology and Epidemiology at the University of Pennsylvania School of Medicine, and Director of both the Ocular Inflammation Service and Ophthalmic Epidemiology. His research centers on the effects of treatment for patients with ocular inflammatory and infectious diseases. Dr Kempen serves as Chairman of the Systemic Immunosuppressive Therapy for Eye Diseases (SITE) Cohort Study and as Vice-Chairman of the Multicenter Uveitis Steroid Treatment
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Dr John H. Kempen is an Associate Professor of Ophthalmology and Epidemiology at the University of Pennsylvania School of Medicine, and Director of both the Ocular Inflammation Service and Ophthalmic Epidemiology. His research centers on the effects of treatment for patients with ocular inflammatory and infectious diseases. Dr Kempen serves as Chairman of the Systemic Immunosuppressive Therapy for Eye Diseases (SITE) Cohort Study and as Vice-Chairman of the Multicenter Uveitis Steroid Treatment (MUST) Trial.