临床眼科杂志2023，Vol.31Issue(6)：498-502,5.DOI:10.3969/j.issn.1006-8422.2023.06.004
早产儿视网膜病变国际分类的一致性评估
Interobserver agreement of international classification of retinopathy of prematurity
摘要
Abstract
Objective To observe the interobserver agreement of classification of retinopathy of prematurity(ROP)by ophthalmologists with different clinical experience.Methods It was a cross-sectional study.118 eyes of 59 pa-tients with ROP who diagnosed in the ophthalmology department of Sichuan Provincial People's Hospital from January 2021 to June 2022 were included in the study.The clinical data of birth weight,gestational age,sex and fundus color photogra-phy were collected in detail.Four independent ophthalmologists(A,B,C,D)with different clinical experience engaged in ROP screening and diagnosis and treatment independently interpreted the color fundus images of patients based on the in-ternational classification standard of ROP and with reference to the Chinese Guidelines for Screening Retinopathy of Preterm Infants(2014).Severe ROP was defined as Type 1 ROP,(1)including Zone Ⅰ stage 1+,Zone Ⅰ stage 2+,Zone Ⅰ stage 3+and Zone Ⅰ stage 3;(2)Zone Ⅱ stage 2+or 3+;(3)Aggressive ROP(A-ROP).Mild ROP was defined as other ROP that did not reach Type 1 severity.Kappa(κ)test was used to analyze the consistency of classification results be-tween ophthalmologists A,B,C,and D.κ value ≤0.4 indicates low consistency,0.4＜κ value≤0.6 indicates moder-ate consistency,and κ value＞0.6 indicates strong consistency.Results According to the diagnosis of doctor D,there were114 eyes(94.9％)with ROP,of which 94 eyes(82.5％)were mild ROP,20 eyes(17.5％)with severe ROP,plus disease were found in 16 eyes(14％).The consistency of ROP typing results between ophthalmologists A,B,C and physician D were 75.4％、90.7％and 91.5％,respectively,κ value were 0.412、0.713 and 0.863 respectively.The con-sistency of diagnosis for plus disease were 77.1％,92.4％and 96.6％respectively,κ values were 0.401、0.662 and 0.699 respectively.Conclusions There are differences in the consistency of classification of ROP among ophthalmologists with different clinical experience,and the consistency will gradually increase with the accumulation of clinical experience.关键词
早产儿视网膜病变/诊断/一致性Key words
Retinopathy of prematurity/Diagnosis/Consistency引用本文复制引用
蒋弘杨,黎梦宇,李红,刘洋,邓铂林,董文韬..早产儿视网膜病变国际分类的一致性评估[J].临床眼科杂志,2023,31(6):498-502,5.基金项目
四川省科技计划项目(2022YFS0234) （2022YFS0234）
四川省人民医院青年科研基金(2017QN02) （2017QN02）
电子科技大学中央高校基金(2672018ZYGX2018J098) （2672018ZYGX2018J098）
