Fankhauser F, Larsen S E, Cruz-Orive L M
Lindenhof Hospital, Berne, Switzerland.
Ger J Ophthalmol. 1994 Jan;3(1):43-7.
A total of 189 numerical printouts of the visual fields of 189 eyes of individuals either suspected of or verified as having glaucoma and displaying varying degrees of glaucomatous visual field damage were analyzed by one expert interpreter. The amount of clusters (or scotomas) was counted and delineated in each visual field under both a more stringent and a more liberal criterion. The interpretations of the visual fields differed significantly in both groups, as did the subjective certainty the interpreter allotted to his assessment. In the group of certain decisions, only 144 defects were assessed as opposed to 364 when a more stringent rather than a more liberal criterion was adopted. In uncertain cases, a reverse trend was observed, since only 11 as opposed to 324 defects were assessed when a more liberal rather than a more stringent criterion was adopted. Both trends may be explained by an increase in sensitivity at the expense of specificity (i.e., a change in the receiver-operating characteristic of the expert when the latter is pressed to change the criterion in a subjective cluster or scotoma assessment task). The ambiguity of the task and the difference in the criterion adopted by the interpreter significantly influences the assessment of normality and pathology, in particular its extent and spatial distribution.
一位专业口译员对189名疑似或确诊患有青光眼且表现出不同程度青光眼性视野损害的个体的189只眼睛的视野进行了总共189次数值打印输出分析。在更严格和更宽松的标准下，对每个视野中的簇（或暗点）数量进行了计数和描绘。两组视野的解读存在显著差异，口译员对其评估的主观确定性也存在差异。在确定的决策组中，采用更严格而非更宽松的标准时，仅评估了144个缺陷，而采用更宽松标准时评估了364个缺陷。在不确定的情况下，观察到相反的趋势，因为采用更宽松而非更严格的标准时，仅评估了11个缺陷，而采用更严格标准时评估了324个缺陷。这两种趋势都可以通过以特异性为代价的敏感性增加来解释（即，当专家在主观簇或暗点评估任务中被迫改变标准时，其接受者操作特征发生变化）。任务的模糊性和口译员采用的标准差异显著影响了正常和病理的评估，特别是其程度和空间分布。
