RT Journal Article
SR Electronic
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
FD BMJ Publishing Group Ltd.
SP 762
OP 765
DO 10.1136/bjophthalmol-2015-307224
VO 100
IS 6
A1 Bidya P Prasad
A1 Ramesh C Bhatta
A1 JSP Chaudhary
A1 Shekhar Sharma
A1 Sailesh Mishra
A1 Puja A Cuddapah
A1 Nicole E Stoller
A1 Sun N Yu
A1 Salman A Rahman
A1 Michael Deiner
A1 Jeremy D Keenan
A1 Bruce D Gaynor
YR 2016
UL http://bjo.bmj.com/content/100/6/762.abstract
AB 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.