TY - JOUR T1 - Agreement between novice and experienced trachoma graders improves after a single day of didactic training JF - British Journal of Ophthalmology JO - Br J Ophthalmol SP - 762 LP - 765 DO - 10.1136/bjophthalmol-2015-307224 VL - 100 IS - 6 AU - Bidya P Prasad AU - Ramesh C Bhatta AU - JSP Chaudhary AU - Shekhar Sharma AU - Sailesh Mishra AU - Puja A Cuddapah AU - Nicole E Stoller AU - Sun N Yu AU - Salman A Rahman AU - Michael Deiner AU - Jeremy D Keenan AU - Bruce D Gaynor Y1 - 2016/06/01 UR - http://bjo.bmj.com/content/100/6/762.abstract N2 - Background/aims Prevalence estimates and treatment decisions for trachoma are based entirely on ocular clinical examination. The aim of the current study is to demonstrate that ophthalmic assistants can be trained and certified to provide trachoma grading within a single day.Methods Conjunctival photographs from an area with endemic trachoma were randomised into two sets of 60 cases. Photographs were graded for trachomatous inflammation—follicular (TF) and trachomatous inflammation—intense (TI) by three experienced graders. Inter-rater reliability of eight ophthalmic assistants and three experienced graders were compared before and after training.Results The mean κ agreement between the ophthalmic assistants and the consensus grades of the experienced graders for TF was 0.38 (95% CI 0.18 to 0.58) before training, and increased to 0.60 (95% CI 0.42 to 0.78) after training (p=0.07). The mean κ agreement for TI was 0.16 (95% CI 0.02 to 0.30) before training, and increased to 0.39 (95% CI 0.20 to 0.58) after training (p=0.02).Conclusion A single day of training improves agreement between prospective and experienced trachoma graders, and provides the basis for certification of workers who are able to accurately grade trachoma and generate reliable prevalence estimates. ER -