Agreement among optometrists, ophthalmologists, and residents in evaluating the optic disc for glaucoma

L. S. Abrams, I. U. Scott, G. L. Spaeth, Harry A Quigley, R. Varma

Research output: Contribution to journalArticle

Abstract

Purpose: To determine the agreement among optometrists, ophthalmologists, and ophthalmology residents in assessing glaucomatous optic nerve damage. The authors also determined the sensitivity of each group of observers for identifying glaucomatous optic nerve damage. Methods: Six optometrists, six general ophthalmologists, and six third-year ophthalmology residents evaluated 75 stereoscopic optic disc photographs. Observers estimated the vertical cup:disc ratio (C:D) and assessed the presence of glaucomatous damage. Agreement among and within observers was estimated by the kappa statistic (K(W), k). The sensitivity and specificity for the identification of glaucomatous optic nerve damage were determined for each group of participants. Results: Intraobserver agreement (K(W) 0.69-0.79) was greater than interobserver agreement (K(W) 0.56-0.68) in assessing the C:D ratio and glaucomatous optic nerve damage for optometrists, ophthalmologists, and residents. Interobserver agreement for ophthalmologists (K(W) 0.68) was substantial and significantly higher than for optometrists (K(W) 0.56) and residents (K(W) 0.56) when estimating the C:D ratio. Ophthalmologists and residents had higher sensitivity (78%) in identifying glaucomatous optic nerve damage than did optometrists (56%). The specificity for all three groups was relatively poor (range, 47%-60%). Conclusion: The moderate interobserver agreement across all three groups of observers suggests the need to develop standardized criteria for assessing glaucomatous optic disc damage. Ophthalmologists in this study have a higher interobserver agreement in estimating the C:D ratio and are more sensitive than optometrists in assessing glaucomatous optic nerve damage.

Original languageEnglish (US)
Pages (from-to)1662-1667
Number of pages6
JournalOphthalmology
Volume101
Issue number10
StatePublished - 1994

Fingerprint

Optic Disk
Optic Nerve
Glaucoma
Ophthalmology
Optometrists
Ophthalmologists
Sensitivity and Specificity

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Abrams, L. S., Scott, I. U., Spaeth, G. L., Quigley, H. A., & Varma, R. (1994). Agreement among optometrists, ophthalmologists, and residents in evaluating the optic disc for glaucoma. Ophthalmology, 101(10), 1662-1667.

Agreement among optometrists, ophthalmologists, and residents in evaluating the optic disc for glaucoma. / Abrams, L. S.; Scott, I. U.; Spaeth, G. L.; Quigley, Harry A; Varma, R.

In: Ophthalmology, Vol. 101, No. 10, 1994, p. 1662-1667.

Research output: Contribution to journalArticle

Abrams, LS, Scott, IU, Spaeth, GL, Quigley, HA & Varma, R 1994, 'Agreement among optometrists, ophthalmologists, and residents in evaluating the optic disc for glaucoma', Ophthalmology, vol. 101, no. 10, pp. 1662-1667.
Abrams, L. S. ; Scott, I. U. ; Spaeth, G. L. ; Quigley, Harry A ; Varma, R. / Agreement among optometrists, ophthalmologists, and residents in evaluating the optic disc for glaucoma. In: Ophthalmology. 1994 ; Vol. 101, No. 10. pp. 1662-1667.
@article{9ed38fbd2cdc446a9f209735f610b02c,
title = "Agreement among optometrists, ophthalmologists, and residents in evaluating the optic disc for glaucoma",
abstract = "Purpose: To determine the agreement among optometrists, ophthalmologists, and ophthalmology residents in assessing glaucomatous optic nerve damage. The authors also determined the sensitivity of each group of observers for identifying glaucomatous optic nerve damage. Methods: Six optometrists, six general ophthalmologists, and six third-year ophthalmology residents evaluated 75 stereoscopic optic disc photographs. Observers estimated the vertical cup:disc ratio (C:D) and assessed the presence of glaucomatous damage. Agreement among and within observers was estimated by the kappa statistic (K(W), k). The sensitivity and specificity for the identification of glaucomatous optic nerve damage were determined for each group of participants. Results: Intraobserver agreement (K(W) 0.69-0.79) was greater than interobserver agreement (K(W) 0.56-0.68) in assessing the C:D ratio and glaucomatous optic nerve damage for optometrists, ophthalmologists, and residents. Interobserver agreement for ophthalmologists (K(W) 0.68) was substantial and significantly higher than for optometrists (K(W) 0.56) and residents (K(W) 0.56) when estimating the C:D ratio. Ophthalmologists and residents had higher sensitivity (78{\%}) in identifying glaucomatous optic nerve damage than did optometrists (56{\%}). The specificity for all three groups was relatively poor (range, 47{\%}-60{\%}). Conclusion: The moderate interobserver agreement across all three groups of observers suggests the need to develop standardized criteria for assessing glaucomatous optic disc damage. Ophthalmologists in this study have a higher interobserver agreement in estimating the C:D ratio and are more sensitive than optometrists in assessing glaucomatous optic nerve damage.",
author = "Abrams, {L. S.} and Scott, {I. U.} and Spaeth, {G. L.} and Quigley, {Harry A} and R. Varma",
year = "1994",
language = "English (US)",
volume = "101",
pages = "1662--1667",
journal = "Ophthalmology",
issn = "0161-6420",
publisher = "Elsevier Inc.",
number = "10",

}

TY - JOUR

T1 - Agreement among optometrists, ophthalmologists, and residents in evaluating the optic disc for glaucoma

AU - Abrams, L. S.

AU - Scott, I. U.

AU - Spaeth, G. L.

AU - Quigley, Harry A

AU - Varma, R.

PY - 1994

Y1 - 1994

N2 - Purpose: To determine the agreement among optometrists, ophthalmologists, and ophthalmology residents in assessing glaucomatous optic nerve damage. The authors also determined the sensitivity of each group of observers for identifying glaucomatous optic nerve damage. Methods: Six optometrists, six general ophthalmologists, and six third-year ophthalmology residents evaluated 75 stereoscopic optic disc photographs. Observers estimated the vertical cup:disc ratio (C:D) and assessed the presence of glaucomatous damage. Agreement among and within observers was estimated by the kappa statistic (K(W), k). The sensitivity and specificity for the identification of glaucomatous optic nerve damage were determined for each group of participants. Results: Intraobserver agreement (K(W) 0.69-0.79) was greater than interobserver agreement (K(W) 0.56-0.68) in assessing the C:D ratio and glaucomatous optic nerve damage for optometrists, ophthalmologists, and residents. Interobserver agreement for ophthalmologists (K(W) 0.68) was substantial and significantly higher than for optometrists (K(W) 0.56) and residents (K(W) 0.56) when estimating the C:D ratio. Ophthalmologists and residents had higher sensitivity (78%) in identifying glaucomatous optic nerve damage than did optometrists (56%). The specificity for all three groups was relatively poor (range, 47%-60%). Conclusion: The moderate interobserver agreement across all three groups of observers suggests the need to develop standardized criteria for assessing glaucomatous optic disc damage. Ophthalmologists in this study have a higher interobserver agreement in estimating the C:D ratio and are more sensitive than optometrists in assessing glaucomatous optic nerve damage.

AB - Purpose: To determine the agreement among optometrists, ophthalmologists, and ophthalmology residents in assessing glaucomatous optic nerve damage. The authors also determined the sensitivity of each group of observers for identifying glaucomatous optic nerve damage. Methods: Six optometrists, six general ophthalmologists, and six third-year ophthalmology residents evaluated 75 stereoscopic optic disc photographs. Observers estimated the vertical cup:disc ratio (C:D) and assessed the presence of glaucomatous damage. Agreement among and within observers was estimated by the kappa statistic (K(W), k). The sensitivity and specificity for the identification of glaucomatous optic nerve damage were determined for each group of participants. Results: Intraobserver agreement (K(W) 0.69-0.79) was greater than interobserver agreement (K(W) 0.56-0.68) in assessing the C:D ratio and glaucomatous optic nerve damage for optometrists, ophthalmologists, and residents. Interobserver agreement for ophthalmologists (K(W) 0.68) was substantial and significantly higher than for optometrists (K(W) 0.56) and residents (K(W) 0.56) when estimating the C:D ratio. Ophthalmologists and residents had higher sensitivity (78%) in identifying glaucomatous optic nerve damage than did optometrists (56%). The specificity for all three groups was relatively poor (range, 47%-60%). Conclusion: The moderate interobserver agreement across all three groups of observers suggests the need to develop standardized criteria for assessing glaucomatous optic disc damage. Ophthalmologists in this study have a higher interobserver agreement in estimating the C:D ratio and are more sensitive than optometrists in assessing glaucomatous optic nerve damage.

UR - http://www.scopus.com/inward/record.url?scp=0028033023&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028033023&partnerID=8YFLogxK

M3 - Article

C2 - 7936564

AN - SCOPUS:0028033023

VL - 101

SP - 1662

EP - 1667

JO - Ophthalmology

JF - Ophthalmology

SN - 0161-6420

IS - 10

ER -