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Observer experience and Cup:Disc ratio assessment.

S Hanson·S K Krishnan·J Phillips
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Abstract

BACKGROUND: The validity of the Cup:Disc (C:D) ratio as a clinical measure depends on the level of agreement among observers. In this study, we investigated the effect of observer experience on interobserver and intraobserver agreement in C:D ratio estimation. METHODS: Nine 3rd-year (Yr3) and nine 4th-year (Yr4) optometry students and nine optometrists (Opt), determined C:D ratios from 26 optic disc photographs viewed monoscopically and stereoscopically. Observer agreement was investigated using weighted kappa (Kw) analysis. RESULTS: Interobserver agreement was higher (p < 0.01) among optometrists than among 4th-year students and higher (p < 0.01) among 4th-year than among 3rd-year students (mean Kw: Opt = 0.61; Yr4 = 0.51; Yr3 = 0.39). Stereoscopic estimates of C:D ratios were higher (p < 0.0001) than monoscopic estimates, and interobserver agreement was higher (p < 0.001) when evaluating the vertical rather than the horizontal C:D ratio. Intraobserver agreement (mean Kw: Opt = 0.67; Yr4 = 0.66; Yr3 = 0.62) did not vary significantly (p = 0.78) with experience. CONCLUSIONS: The extent to which an observer reproducibly assesses the C:D ratio from optic disc photographs (intraobserver agreement) does not increase with experience. However, the agreement between different observers in assessing the C:D ratio (interobserver agreement) increases with experience.

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Clinical CompetenceGlaucomaHumansObserver VariationOptic DiskOptic Nerve DiseasesOptometryPhotographyReproducibility of ResultsStudents, MedicalComparative StudyJournal Article

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S Hanson, S K Krishnan, J Phillips. 2001. Observer experience and Cup:Disc ratio assessment.. https://doi.org/10.1097/00006324-200110000-00009

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