Aoki N, Horibe H, Ohno Y, Hayakawa N, Kondo R
Jpn Circ J. 1977 Jan;41(1):11-7. doi: 10.1253/jcj.41.11.
In order to evaluate observer variability and reproducibility for the funduscopic findings, the color slides of one hundred cases in Akabane and Asahi town in Japan were investigated and the following were revealed: 1. Observer variability for Keith-Wagener's classification was the least in the grade 3 and the most in grade 0. The variability of diagnosis between observers was the least for retinal bleeding and the most for anteriolar reflex and remarkable for lateral displacement and arteriolar narrowing. In general, the observe variability was one grade at most. 2. Reproducibility for Scheie's hypertensive classification was 73 per cent and that for Scheie's arteriosclerotic and Keith-Wagner's classifications was 66 per cent. Fairly good reproducibility was observed in retinal bleeding and poor reproducibility in arteriolar reflex and vertical and lateral displacements, In general, the intra-observer variability for the funduscopic findings was one grade at most. 3. Observer variability and reproducibility for the funduscopic findings would be improved by establishment of the detailed diagnostic criteria of various funduscopic findings, taking color pictures in focus and systematic training for the fresh doctors or technicians without enough experience. 4. The cases with definite narrowing of arteriole revealed smaller A/V ratio than 0.70.
为评估眼底检查结果的观察者变异性和可重复性，对日本赤羽和朝日镇100例病例的彩色幻灯片进行了调查，结果如下：1. 观察者对Keith-Wagener分级的变异性在3级最小，在0级最大。观察者之间诊断的变异性对于视网膜出血最小，对于小动脉反射最大，对于侧移位和小动脉狭窄显著。一般来说，观察者变异性最多为一级。2. Scheie高血压分级的可重复性为73%，Scheie动脉硬化分级和Keith-Wagner分级的可重复性为66%。在视网膜出血方面观察到相当好的可重复性，在小动脉反射以及垂直和侧移位方面可重复性较差。一般来说，眼底检查结果的观察者内变异性最多为一级。3. 通过建立各种眼底检查结果的详细诊断标准、拍摄聚焦的彩色照片以及对经验不足的新医生或技术人员进行系统培训，可提高眼底检查结果的观察者变异性和可重复性。4. 小动脉明显狭窄的病例显示动静脉比值小于0.70。
