Feman S S, Leonard-Martin T C, Andrews J S, Armbruster C C, Burdge T L, Debelak J D, Lanier A, Fischer A G
Department of Ophthalmology and Visual Sciences, School of Medicine, Vanderbilt University, Nashville, Tennessee 37232-8808.
Invest Ophthalmol Vis Sci. 1995 Jan;36(1):174-81.
To evaluate a quantitative system to measure the early lesions of diabetic retinopathy seen in stereoscopic fundus photographs.
Using a quantitative classification system, photographs of 4657 eyes (7 stereo pairs of 35-mm slides per eye) were scored for 16 diabetic lesions. A single severity level (identical to the ETDRS Interim Scale) was calculated for each eye. The reliability of this technique, and its reproducibility by independent examiners, was evaluated for individual lesions and severity levels using percent agreement, kappa, and weighted kappa statistics.
This quantitative technique demonstrated an "almost perfect" agreement (weighted kappa > or = 0.810) on all but one lesion by independent observers. For the severity levels, there was a 95.7% perfect agreement (kappa = 0.9428). The reproducibility of agreement over time was "almost perfect" on all but four lesions; with 88% perfect agreement (kappa = 0.8394) for severity levels.
When used to evaluate the early lesions of diabetic retinopathy, the Vanderbilt Classification System is highly reliable between graders and over time. This system can gather quantitative data and evaluate incremental changes in an accurate, reproducible manner.
评估一种用于测量立体眼底照片中糖尿病视网膜病变早期病变的定量系统。
使用定量分类系统，对4657只眼睛（每只眼睛7对35毫米幻灯片的立体照片）的16种糖尿病病变进行评分。为每只眼睛计算单一严重程度等级（与ETDRS临时量表相同）。使用一致性百分比、kappa统计量和加权kappa统计量，针对个体病变和严重程度等级评估该技术的可靠性及其由独立检查者的可重复性。
这种定量技术在除一种病变外的所有病变上，独立观察者之间表现出“几乎完美”的一致性（加权kappa≥0.810）。对于严重程度等级，有95.7%的完美一致性（kappa = 0.9428）。除四种病变外，随着时间推移一致性的可重复性“几乎完美”；对于严重程度等级，有88%的完美一致性（kappa = 0.8394）。
当用于评估糖尿病视网膜病变的早期病变时，范德比尔特分类系统在分级者之间以及随着时间推移具有高度可靠性。该系统可以收集定量数据，并以准确、可重复的方式评估渐进性变化。
