dc.contributor.author | Jindal, Anish | |
dc.contributor.author | Myint, Joy | |
dc.contributor.author | Edgar, David F. | |
dc.contributor.author | Nolan, Winifred P. | |
dc.contributor.author | Lawrenson, John G. | |
dc.date.accessioned | 2016-04-07T11:40:44Z | |
dc.date.available | 2016-04-07T11:40:44Z | |
dc.date.issued | 2015-03 | |
dc.identifier.citation | Jindal , A , Myint , J , Edgar , D F , Nolan , W P & Lawrenson , J G 2015 , ' Agreement among optometrists and ophthalmologists in estimating limbal anterior chamber depth using the van Herick method ' , Ophthalmic and Physiological Optics , vol. 35 , no. 2 , pp. 179-185 . https://doi.org/10.1111/opo.12199 | |
dc.identifier.issn | 0275-5408 | |
dc.identifier.uri | http://hdl.handle.net/2299/17042 | |
dc.description.abstract | Purpose: To evaluate the inter-observer agreement for measuring limbal anterior chamber depth (LACD) using the van Herick test in community optometrists, glaucoma specialist optometrists and ophthalmologists. Methods: The study was divided into two phases. In the first phase, a random sample of 100 UK community optometrists were given an opportunity to select and grade eight digital slit-lamp images of anterior chamber angles using the original van Herick 4 point grading scale. The images were included in a clinical decision making study using computerised virtual case vignettes. In the second phase, hospital-based glaucoma specialist optometrists and glaucoma sub-specialist ophthalmologists graded the LACD of the right eye using a 7-point % grading scale in 57 consecutively presenting patients with suspect glaucoma. Inter-observer agreement was assessed using linearly weighted kappa (κw). Results: Inter-observer agreement for community optometrists was moderate, with a mean κw for grading photographic images of 0.50 (95% confidence interval (CI) 0.43-0.57). Overall, ninety-two percent of observations were within one grade of the actual grade, although grading of narrow angles was associated with a 13% false negative error rate (based on a ≤ grade 2 threshold). For Phase 2 of the study, pairwise comparisons between optometrists and ophthalmologists showed that agreement was moderate to substantial (mean κw = 0.54-0.65) with a false negative rate of 1.9% (based on a ≤ 25% threshold). Grading accuracy of specialist optometrists and ophthalmologists were equivalent. Conclusions: In summary, the present study found that community optometrists showed moderate inter-observer agreement for grading LACD. Glaucoma specialist optometrists showed moderate to substantial agreement with weighted kappa values that were equivalent to sub-specialist ophthalmologists. The augmented 7-point % grading scale is intuitive and potentially offers greater accuracy for grading narrow angles than the traditional 4-point scale for grading LACD. | en |
dc.format.extent | 7 | |
dc.language.iso | eng | |
dc.relation.ispartof | Ophthalmic and Physiological Optics | |
dc.subject | Angle closure | |
dc.subject | Inter-observer agreement | |
dc.subject | Van Herick test | |
dc.subject | Ophthalmology | |
dc.subject | Optometry | |
dc.subject | Sensory Systems | |
dc.subject | General Medicine | |
dc.title | Agreement among optometrists and ophthalmologists in estimating limbal anterior chamber depth using the van Herick method | en |
dc.contributor.institution | School of Life and Medical Sciences | |
dc.contributor.institution | Department of Pharmacy, Pharmacology and Postgraduate Medicine | |
dc.contributor.institution | Postgraduate Medicine | |
dc.description.status | Peer reviewed | |
rioxxterms.versionofrecord | 10.1111/opo.12199 | |
rioxxterms.type | Journal Article/Review | |
herts.preservation.rarelyaccessed | true | |