Agreement on Grading Retinal Findings of Patients with Diabetes Using Fundus Photographs by Allied Medical Personnel when Compared to an Ophthalmologist at a Diabetic Retinopathy Screening Program in Nepal

Figures & data

Table 1 Intra-Rater Agreement of AMP on Retinal Findings in 3 Month and 6 Months

Retinal Findings	Time (Months)	AMP 1 K (95% CI)	AMP 2 K (95% CI)	AMP 3 K (95% CI)	AMP 4 K (95% CI)	AMP 5 K (95% CI)	AMP 6 K (95% CI)
Any retinal pathologies	3	0.84 (0.74–0.93)	0.81 (0.68–0.89)	0.84 (0.71–0.92)	0.65 (0.53–0.75)	0.67 (o.54–0.78)	0.76 (0.63–0.89)
	6	0.86 (0.74–0.94)	0.80 (0.68–0.90)	0.85 (0.73–0.96)	0.79 (0.69–0.87)	0.59 (0.47–0.69)	0.71 (0.57–0.84)
Retinal hemorrhage	3	0.08 (0–0.46)	0.76 (0.43–0.90)	0.41 (0.13–0.71)	0.73 (0.46–0.86)	0.58 (0.36–0.86)	0.76 (0.56–1.0)
	6	0.75 (0.50–1.00)	1.00	0.24 (0.22–0.64)	0.77 (0.55–0.99)	0.36 (0–0.63)	0.70 (0.30–1.00)
Macular Exudates	3	0.70 (0.45–0.98)	0.75 (0.47–0.95)	0.76 (0.44–0.97)	0.62 (0.29–0.81)	0.54 (0.28–0.80)	0.70 (0.34–0.91)
	6	0.57 (0.12–3.88)	0.66 (0.13–4.07)	0.86 (0.14–4.07)	0.84 (0.09–5.19)	0.82 (0.09–5.07)	0.73 (0.14–3.54)
Abnormal optic disc	3	0.39 (0.00–0.75)	0.51 (0.19–0.79)	0.46 (0.18–0.71)	0.48 (0.15–0.70)	−.02 (−.03–0.00)	0.35 (−.02–0.66)
	6	0.66 (0.45–0.77)	0.84 (0.76–0.89)	0.74 (0.60–0.80)	0.56 (0.10–0.80)	0.43 (0.32–0.52)	0.29 (0.02–0.57)

Note: * Means 95% CI could not be calculated in SPSS version 20.

Abbreviations: AMP, allied medical personnel, CI, confidence interval, k, kappa.

Table 2 Inter-Rater Agreement of AMP on Retinal Findings in 3 Month and 6 Months at the First Rating

Retinal Findings	Time (Months)	Kappa (95% CI)	Sensitivity (%)	Specificity (%)
Any retinal pathologies	3	0.68 (0.63–0.73)	90.48	83.67
	6	0.68 (0.63–0.73)	65.52	97.02
Retinal hemorrhage	3	0.52 (0.36–0.64)	81.08	83.24
	6	0.68 (0.63–0.73)	66.67	82.97
Macular Exudates	3	0.40 (0.29–0.51)	83.72	58.87
	6	0.48 (0.35–0.58)	82.50	68.22
Other retinal pathologies	3	0.40 (0.26–0.55)	94.04	40.68
	6	0.38 (0.22–0.54)	93.17	39.58
Abnormal optic disc	3	0.20 (0.15–0.26)	85.77	98.45
	6	0.32 (0–0.80)	99.03	33.33

Abbreviations: AMP, allied medical personnel, CI, confidence interval.

Table 3 Inter-Rater Agreement of AMP on Retinal Findings in 3 Months and 6 Months at the Second Rating

Retinal Findings	Time (Months)	Kappa (95% CI)	Sensitivity (%)	Specificity (%)
Any retinal pathologies	3	0.60 (0.55–0.64)	87.45	76.45
	6	0.61 (0.56–0.66)	59.54	95.79
Retinal hemorrhage	3	0.48 (0.36–0.60)	84.09	77.78
	6	0.30 (0.13–0.43)	62.5	80.54
Macular Exudates	3	0.35 (0.25–0.46)	83.72	58.87
	6	0.49 (0.36–0.61)	90.28	62.96
Other retinal pathologies	3	0.42 (0.28–0.55)	92.90	44.93
	6	0.33 (0.18–0.47)	91.67	37.25
Abnormal optic disc	3	0.04 (0.03–0.06)	67.84	98.74
	6	0.32 (0-0.79)	99.03	33.33

Abbreviations: AMP, allied medical personnel, CI, confidence interval.