Importance of Including Borderline Cases in Trachoma Grader Certification

Overview

Journal Am J Trop Med Hyg

Specialty Tropical Medicine

Date 2014 Jul 9

PMID 25002297

Citations 5

Authors

Bruce D Gaynor

Abdou Amza

Sintayehu Gebresailassie

Boubacar Kadri

Baido Nassirou

Nicole E Stoller

Sun N Yu

Puja A Cuddapah

Jeremy D Keenan

Thomas M Lietman

Affiliations

Soon will be listed here.

Abstract

We assessed trachoma grading agreement among field graders using photographs that included the complete spectrum of disease and compared it with cases where there was consensus among experienced graders. Trained photographers took photographs of children's conjunctiva during a clinical trial in Ethiopia. We calculated κ-agreement statistics using a complete set of 60 cases and then recalculated the κ using a consensus set where cases were limited to those cases with agreement among experienced graders. When the complete set of 60 cases was used, agreement was moderate (κ = 0.61, 95% confidence interval [95% CI] = 0.56-0.67). When the consensus set was used, agreement improved significantly (κ = 0.75, 95% CI = 0.68-0.80). The κ of the consensus set was higher than the complete set by 0.14 (95% CI = 0.12-0.16) (P < 0.001). If testing sets remove difficult-to-grade cases, agreement in trachoma grading may be higher than actually seen in population-based trachoma surveys.

Citing Articles

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The Impact of Image Quality and Trachomatous Inflammation on Using Photography for Trachoma Prevalence Surveys.

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