School of Biomedical Informatics, University of Texas Health Science Center, Houston, Texas, USA.
Invest Ophthalmol Vis Sci. 2010 Nov;51(11):5846-52. doi: 10.1167/iovs.09-4803. Epub 2010 May 19.
To assess agreement between digital and film photography for research classification of diabetic retinopathy severity.
Digital and film photographs from a 152-eye cohort with a full spectrum of Early Treatment Diabetic Retinopathy Study (ETDRS) severity levels were assessed for repeatability of grading within each image medium and for agreement on ETDRS discrete severity levels, ascending severity thresholds, and presence or absence of diabetic retinopathy index lesions, between digital and 35-mm slides (film). Digital photographs were color balanced to match film.
There was substantial agreement (κ = 0.61, κ(w) [linear weighted] = 0.87) in classification of ETDRS diabetic retinopathy severity levels between digital images and film. Marginal homogeneity analyses found no significant difference in frequency distributions on the severity scale (P = 0.21, Bhapkar test). The κ results ranged from 0.72 to 0.95 for presence or absence of eight ascending diabetic retinopathy severity thresholds. Repeatability of grading between readers viewing digital images was equal to or better than that obtained with film (pair-wise interreader κ for digital images ranged from 0.47 to 0.57 and for film from 0.43 to 0.57. The κ results for identifying diabetic retinopathy lesions ranged from moderate to almost perfect. Moderate agreement of intraretinal microvascular abnormalities and venous beading between digital images and film accounted for slightly lower concordance for severity thresholds ≥47 and for slightly lower interreader agreement within digital and film images at severity thresholds ≥43 and ≥47.
Under controlled circumstances, digital photography can equal the reliability of 35-mm slides for research classification of ETDRS severity level.
评估数码摄影和胶片摄影在糖尿病视网膜病变严重程度的研究分类中的一致性。
对来自一个 152 只眼队列的数码和胶片照片进行评估，这些照片涵盖了早期治疗糖尿病视网膜病变研究（ETDRS）的所有严重程度水平，以评估在每种图像介质内分级的重复性，以及在 ETDRS 离散严重程度水平、递增严重程度阈值以及糖尿病视网膜病变指数病变的存在或缺失方面，数码和 35mm 幻灯片（胶片）之间的一致性。数码照片的颜色平衡以匹配胶片。
在数码图像和胶片之间，ETDRS 糖尿病视网膜病变严重程度分级具有高度一致性（κ=0.61，κ（w）[线性加权]=0.87）。边缘同质性分析发现严重程度尺度上的频率分布没有显著差异（P=0.21，Bhapkar 检验）。在存在或不存在八个递增的糖尿病视网膜病变严重程度阈值方面，κ 结果范围为 0.72 至 0.95。两位读者观看数码图像时的分级重复性与使用胶片时相等或更好（数码图像的两两读者间κ值范围为 0.47 至 0.57，而胶片的κ值范围为 0.43 至 0.57）。识别糖尿病视网膜病变病变的κ 结果从中度到几乎完美。在数码图像和胶片之间，视网膜内微血管异常和静脉串珠的中度一致性导致在严重程度阈值≥47 时的一致性略低，并且在严重程度阈值≥43 和≥47 时，在数码和胶片图像内的读者间一致性略低。
在受控条件下，数码摄影可以与 35mm 幻灯片的可靠性相媲美，用于 ETDRS 严重程度分级的研究分类。
