Inter-grader Agreement of the Ocular Staining Score in the Sjögren's International Clinical Collaborative Alliance (SICCA) Registry

Jennifer Rose-Nussbaumer, Thomas M. Lietman, Caroline H. Shiboski, Stephen C. Shiboski, Vatinee Y. Bunya, Esen K Akpek, Muthiah Srinivasan, Jeena Mascarenhas, Giacomina Massaro-Giordano, Nancy A. McNamara, John P. Whitcher, Bruce D. Gaynor

Research output: Contribution to journalArticle

Abstract

Purpose To determine the intra-observer and inter-observer reliability of a novel ocular staining score among trained ophthalmologists. Design Reliability analysis within a prospective, observational, multicenter cohort study. Methods Those enrolled in the National Institutes of Health-funded Sjögren's International Collaborative Clinical Alliance (SICCA) who presented for follow-up at the University of California San Francisco, Aravind Eye Hospital, Johns Hopkins University, and the University of Pennsylvania were included. Study participants were graded using the ocular staining score by at least 2 masked SICCA-trained ophthalmologists. The primary outcome for this study was the intraclass correlation coefficient (ICC) for the total ocular staining score. ICCs were also calculated for tear break-up time (TBUT) and conjunctival and corneal staining. Results Total ocular staining score had an ICC of 0.91 for the right eye (95% confidence interval [CI] 0.85-0.96) and 0.90 for the left eye (95% CI 0.83-0.97). Corneal staining (right eye 0.86, 95% CI 0.76-0.93, left eye 0.90, 95% CI 0.81-0.95) and conjunctival staining (right eye 0.87, 95% CI 0.80-0.93, left eye 0.85, 95% CI 0.75-0.93) demonstrated excellent agreement. The ICC for TBUT was slightly lower (right eye 0.77, 95% CI 0.64-0.89; left eye 0.81, 95% CI 0.68-0.90). Conclusions Previous studies have shown that the ocular staining score is correlated with other diagnostic components of Sjögren syndrome. In this study, we demonstrate high reliability in grading among trained ophthalmologists, completing the validation of this test.

Original languageEnglish (US)
Pages (from-to)1150-1153
Number of pages4
JournalAmerican Journal of Ophthalmology
Volume160
Issue number6
DOIs
StatePublished - 2015

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Registries
Staining and Labeling
Confidence Intervals
Tears
San Francisco
National Institutes of Health (U.S.)
Multicenter Studies
Cohort Studies
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Ophthalmology

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Inter-grader Agreement of the Ocular Staining Score in the Sjögren's International Clinical Collaborative Alliance (SICCA) Registry. / Rose-Nussbaumer, Jennifer; Lietman, Thomas M.; Shiboski, Caroline H.; Shiboski, Stephen C.; Bunya, Vatinee Y.; Akpek, Esen K; Srinivasan, Muthiah; Mascarenhas, Jeena; Massaro-Giordano, Giacomina; McNamara, Nancy A.; Whitcher, John P.; Gaynor, Bruce D.

In: American Journal of Ophthalmology, Vol. 160, No. 6, 2015, p. 1150-1153.

Research output: Contribution to journalArticle

Rose-Nussbaumer, J, Lietman, TM, Shiboski, CH, Shiboski, SC, Bunya, VY, Akpek, EK, Srinivasan, M, Mascarenhas, J, Massaro-Giordano, G, McNamara, NA, Whitcher, JP & Gaynor, BD 2015, 'Inter-grader Agreement of the Ocular Staining Score in the Sjögren's International Clinical Collaborative Alliance (SICCA) Registry', American Journal of Ophthalmology, vol. 160, no. 6, pp. 1150-1153. https://doi.org/10.1016/j.ajo.2015.08.021
Rose-Nussbaumer, Jennifer ; Lietman, Thomas M. ; Shiboski, Caroline H. ; Shiboski, Stephen C. ; Bunya, Vatinee Y. ; Akpek, Esen K ; Srinivasan, Muthiah ; Mascarenhas, Jeena ; Massaro-Giordano, Giacomina ; McNamara, Nancy A. ; Whitcher, John P. ; Gaynor, Bruce D. / Inter-grader Agreement of the Ocular Staining Score in the Sjögren's International Clinical Collaborative Alliance (SICCA) Registry. In: American Journal of Ophthalmology. 2015 ; Vol. 160, No. 6. pp. 1150-1153.
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title = "Inter-grader Agreement of the Ocular Staining Score in the Sj{\"o}gren's International Clinical Collaborative Alliance (SICCA) Registry",
abstract = "Purpose To determine the intra-observer and inter-observer reliability of a novel ocular staining score among trained ophthalmologists. Design Reliability analysis within a prospective, observational, multicenter cohort study. Methods Those enrolled in the National Institutes of Health-funded Sj{\"o}gren's International Collaborative Clinical Alliance (SICCA) who presented for follow-up at the University of California San Francisco, Aravind Eye Hospital, Johns Hopkins University, and the University of Pennsylvania were included. Study participants were graded using the ocular staining score by at least 2 masked SICCA-trained ophthalmologists. The primary outcome for this study was the intraclass correlation coefficient (ICC) for the total ocular staining score. ICCs were also calculated for tear break-up time (TBUT) and conjunctival and corneal staining. Results Total ocular staining score had an ICC of 0.91 for the right eye (95{\%} confidence interval [CI] 0.85-0.96) and 0.90 for the left eye (95{\%} CI 0.83-0.97). Corneal staining (right eye 0.86, 95{\%} CI 0.76-0.93, left eye 0.90, 95{\%} CI 0.81-0.95) and conjunctival staining (right eye 0.87, 95{\%} CI 0.80-0.93, left eye 0.85, 95{\%} CI 0.75-0.93) demonstrated excellent agreement. The ICC for TBUT was slightly lower (right eye 0.77, 95{\%} CI 0.64-0.89; left eye 0.81, 95{\%} CI 0.68-0.90). Conclusions Previous studies have shown that the ocular staining score is correlated with other diagnostic components of Sj{\"o}gren syndrome. In this study, we demonstrate high reliability in grading among trained ophthalmologists, completing the validation of this test.",
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T1 - Inter-grader Agreement of the Ocular Staining Score in the Sjögren's International Clinical Collaborative Alliance (SICCA) Registry

AU - Rose-Nussbaumer, Jennifer

AU - Lietman, Thomas M.

AU - Shiboski, Caroline H.

AU - Shiboski, Stephen C.

AU - Bunya, Vatinee Y.

AU - Akpek, Esen K

AU - Srinivasan, Muthiah

AU - Mascarenhas, Jeena

AU - Massaro-Giordano, Giacomina

AU - McNamara, Nancy A.

AU - Whitcher, John P.

AU - Gaynor, Bruce D.

PY - 2015

Y1 - 2015

N2 - Purpose To determine the intra-observer and inter-observer reliability of a novel ocular staining score among trained ophthalmologists. Design Reliability analysis within a prospective, observational, multicenter cohort study. Methods Those enrolled in the National Institutes of Health-funded Sjögren's International Collaborative Clinical Alliance (SICCA) who presented for follow-up at the University of California San Francisco, Aravind Eye Hospital, Johns Hopkins University, and the University of Pennsylvania were included. Study participants were graded using the ocular staining score by at least 2 masked SICCA-trained ophthalmologists. The primary outcome for this study was the intraclass correlation coefficient (ICC) for the total ocular staining score. ICCs were also calculated for tear break-up time (TBUT) and conjunctival and corneal staining. Results Total ocular staining score had an ICC of 0.91 for the right eye (95% confidence interval [CI] 0.85-0.96) and 0.90 for the left eye (95% CI 0.83-0.97). Corneal staining (right eye 0.86, 95% CI 0.76-0.93, left eye 0.90, 95% CI 0.81-0.95) and conjunctival staining (right eye 0.87, 95% CI 0.80-0.93, left eye 0.85, 95% CI 0.75-0.93) demonstrated excellent agreement. The ICC for TBUT was slightly lower (right eye 0.77, 95% CI 0.64-0.89; left eye 0.81, 95% CI 0.68-0.90). Conclusions Previous studies have shown that the ocular staining score is correlated with other diagnostic components of Sjögren syndrome. In this study, we demonstrate high reliability in grading among trained ophthalmologists, completing the validation of this test.

AB - Purpose To determine the intra-observer and inter-observer reliability of a novel ocular staining score among trained ophthalmologists. Design Reliability analysis within a prospective, observational, multicenter cohort study. Methods Those enrolled in the National Institutes of Health-funded Sjögren's International Collaborative Clinical Alliance (SICCA) who presented for follow-up at the University of California San Francisco, Aravind Eye Hospital, Johns Hopkins University, and the University of Pennsylvania were included. Study participants were graded using the ocular staining score by at least 2 masked SICCA-trained ophthalmologists. The primary outcome for this study was the intraclass correlation coefficient (ICC) for the total ocular staining score. ICCs were also calculated for tear break-up time (TBUT) and conjunctival and corneal staining. Results Total ocular staining score had an ICC of 0.91 for the right eye (95% confidence interval [CI] 0.85-0.96) and 0.90 for the left eye (95% CI 0.83-0.97). Corneal staining (right eye 0.86, 95% CI 0.76-0.93, left eye 0.90, 95% CI 0.81-0.95) and conjunctival staining (right eye 0.87, 95% CI 0.80-0.93, left eye 0.85, 95% CI 0.75-0.93) demonstrated excellent agreement. The ICC for TBUT was slightly lower (right eye 0.77, 95% CI 0.64-0.89; left eye 0.81, 95% CI 0.68-0.90). Conclusions Previous studies have shown that the ocular staining score is correlated with other diagnostic components of Sjögren syndrome. In this study, we demonstrate high reliability in grading among trained ophthalmologists, completing the validation of this test.

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