Baldwin Angela, Ryner Alexander M, Tadesse Zerihun, Shiferaw Ayalew, Callahan Kelly, Fry Dionna M, Zhou Zhaoxia, Lietman Thomas M, Keenan Jeremy D
School of Public Health, University of California, Berkeley, California.
Francis I. Proctor Foundation, University of California, San Francisco, California.
Am J Trop Med Hyg. 2017 Jun;96(6):1378-1381. doi: 10.4269/ajtmh.16-0958.
AbstractWe evaluated a new trachoma scarring ranking system with potential use in clinical research. The upper right tarsal conjunctivas of 427 individuals from Ethiopian villages with hyperendemic trachoma were photographed. An expert grader first assigned a scar grade to each photograph using the 1981 World Health Organization (WHO) grading system. Then, all photographs were ranked from least (rank = 1) to most scarring (rank = 427). Photographic grading found 79 (18.5%) conjunctivae without scarring (C0), 191 (44.7%) with minimal scarring (C1), 105 (24.6%) with moderate scarring (C2), and 52 (12.2%) with severe scarring (C3). The ranking method demonstrated good internal validity, exhibiting a monotonic increase in the median rank across the levels of the 1981 WHO grading system. Intrarater repeatability was better for the ranking method (intraclass correlation coefficient = 0.84, 95% CI = 0.74-0.94). Exhibiting better internal and external validity, this ranking method may be useful for evaluating the difference in scarring between groups of individuals.
摘要
我们评估了一种可用于临床研究的新型沙眼瘢痕分级系统。对来自埃塞俄比亚沙眼高度流行村庄的427名个体的右上睑结膜进行了拍照。一名专家分级员首先使用1981年世界卫生组织（WHO）分级系统为每张照片指定一个瘢痕等级。然后，将所有照片从瘢痕最少（等级 = 1）到瘢痕最多（等级 = 427）进行排序。照片分级发现79例（18.5%）结膜无瘢痕（C0），191例（44.7%）有轻微瘢痕（C1），105例（24.6%）有中度瘢痕（C2），52例（12.2%）有重度瘢痕（C3）。排序方法显示出良好的内部效度，在1981年WHO分级系统的各等级中，中位数等级呈单调增加。排序方法的评分者内重复性更好（组内相关系数 = 0.84，95%置信区间 = 0.74 - 0.94）。这种排序方法具有更好地内部和外部效度，可能有助于评估个体组之间瘢痕形成的差异。
