What's new AAPOS 2008 - The Private Eye Clinic

same diagnosis in 4 of 34 images (12%), and the mean weighted ĸ statistic for each
expert compared with all others was fair agreement for 7 experts (32%), and moderate
agreement for 15 experts (68%). In the 2-level categorization, all experts who provided
a diagnosis agreed in 7 of 34 images (21%), and the mean ĸ statistic for each expert
compared with all others was slight agreement for 1 expert (5%), fair agreement for 3
experts (14%), moderate agreement for 12 experts (55), and substantial agreement for
6 experts (27%).
Conclusions: Interexpert agreement of plus disease diagnosis is imperfect. This may
have important implications for clinical ROP management, continued refinement of the
international ROP classification system, development of computer-based diagnostic
algorithms, and implementation of ROP telemedicine systems.
The Editorial Comment by Dale L. Phelps, M.D., on page 963 of this issue of Archives,
provides excellent remarks to this report.
Plus disease in retinopathy of prematurity: Pilot study of computer-based and
expert diagnosis.
Gelman R, Jiang L, Du Y, Martinez-Perez E, Flynn J, Chiang M.
J AAPOS 2007, Dec; 11(6); 533
Twenty-two ROP experts were asked to interpret a set of 34 wide-angle retinal images
for the presence of plus disease. Images were also analyzed by a computer-based
image analysis Retinal Image multiScale Analysis (RISA). The computer-based
analysis included integrated curvature (IC), diameter, and tortusity index (TI). The RISA
diagnosis of plus disease was compared with the reference standard, as were the
expert panels’ diagnosis. When using the arteriolar IC and TI, the venular diameter, IC
and TI, the RISA system was better at diagnosing plus disease than 18 of the 22
experts (81.8%)
The dilemma of digital imaging in retinopathy of prematurity.
Quinn G.
J AAPOS 2007, Dec.11(6): 529
Nice editorial by Dr. Quinn on the difficulties of diagnosing ‘serious” ROP and absence
of a quantitative standard for plus disease and the two prototype digital imaging analysis
systems.
5