Reliability of grading retinal hemorrhages in abusive head trauma. 2013

Manpreet S Chhabra, and Dean J Bonsall, and Amy E Cassedy, and Gregory H Wallace, and Scott D Schoenberger, and Constance E West
Division of Pediatric Ophthalmology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA. manpreetch@yahoo.com

OBJECTIVE To study the intra- and inter-observer reliability of pediatric ophthalmologists in grading retinal hemorrhages in abusive head trauma. METHODS Pediatric ophthalmologists attending the 2009 annual meeting of the American Association for Pediatric Ophthalmology and Strabismus participated in an onsite survey. The participants were required to compare a collection of fundus photographs of patients with abusive head trauma to two standardized photographs, A and B. Participants graded photographs as normal (no retinal hemorrhages), better than A but not normal, same as A, between A and B, same as B, or worse than B. The survey was divided into four parts: part 1 consisted of 20 photographs to be graded; part 2 was a questionnaire about participant's professional experience; part 3 consisted of 20 photographs to be graded (including 15 graded in part 1 but reordered); and part 4 asked about the criteria used to grade the photographs. RESULTS Of the 95 participants, 92 (97%) were licensed physicians with a mean of 14 years in practice. The intra-rater reliability was found to be high, with overall average of 85% pre- and post-agreement on the common pictures. Kendall's coefficient of concordance was used as the statistical measure of inter-rater reliability and had a high value (0.82). CONCLUSIONS Pediatric ophthalmologists showed high intra- and inter-observer reliability in grading retinal hemorrhages in abusive head trauma.

UI MeSH Term Description Entries
D010781 Photography Method of making images on a sensitized surface by exposure to light or other radiant energy. Photographies
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002649 Child Abuse Abuse of children in a family, institutional, or other setting. (APA, Thesaurus of Psychological Index Terms, 1994) Abuse Experiences, Childhood,Child Neglect,Child Neglect Experiences,Child Neglect, Physical,Childhood Abuse Experiences,Childhood Neglect Experiences,Neglect Experience, Childhood,Neglect Experiences, Childhood,Physical Neglect, Childhood,Child Maltreatment,Child Mistreatment,Abuse Experience, Childhood,Abuse, Child,Child Neglect Experience,Childhood Abuse Experience,Childhood Neglect Experience,Childhood Physical Neglect,Childhood Physical Neglects,Experience, Child Neglect,Experience, Childhood Abuse,Experience, Childhood Neglect,Maltreatment, Child,Mistreatment, Child,Neglect Experience, Child,Neglect, Child,Neglect, Childhood Physical,Neglect, Physical Child,Physical Child Neglect,Physical Child Neglects
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012166 Retinal Hemorrhage Bleeding from the vessels of the retina. Hemorrhage, Retinal,Retinal Hemorrhages
D015203 Reproducibility of Results The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results. Reliability and Validity,Reliability of Result,Reproducibility Of Result,Reproducibility of Finding,Validity of Result,Validity of Results,Face Validity,Reliability (Epidemiology),Reliability of Results,Reproducibility of Findings,Test-Retest Reliability,Validity (Epidemiology),Finding Reproducibilities,Finding Reproducibility,Of Result, Reproducibility,Of Results, Reproducibility,Reliabilities, Test-Retest,Reliability, Test-Retest,Result Reliabilities,Result Reliability,Result Validities,Result Validity,Result, Reproducibility Of,Results, Reproducibility Of,Test Retest Reliability,Validity and Reliability,Validity, Face
D015588 Observer Variation The failure by the observer to measure or identify a phenomenon accurately, which results in an error. Sources for this may be due to the observer's missing an abnormality, or to faulty technique resulting in incorrect test measurement, or to misinterpretation of the data. Two varieties are inter-observer variation (the amount observers vary from one another when reporting on the same material) and intra-observer variation (the amount one observer varies between observations when reporting more than once on the same material). Bias, Observer,Interobserver Variation,Intraobserver Variation,Observer Bias,Inter-Observer Variability,Inter-Observer Variation,Interobserver Variability,Intra-Observer Variability,Intra-Observer Variation,Intraobserver Variability,Inter Observer Variability,Inter Observer Variation,Inter-Observer Variabilities,Inter-Observer Variations,Interobserver Variabilities,Interobserver Variations,Intra Observer Variability,Intra Observer Variation,Intra-Observer Variabilities,Intra-Observer Variations,Intraobserver Variabilities,Intraobserver Variations,Observer Variations,Variabilities, Inter-Observer,Variabilities, Interobserver,Variabilities, Intra-Observer,Variabilities, Intraobserver,Variability, Inter-Observer,Variability, Interobserver,Variability, Intra-Observer,Variability, Intraobserver,Variation, Inter-Observer,Variation, Interobserver,Variation, Intra-Observer,Variation, Intraobserver,Variation, Observer,Variations, Inter-Observer,Variations, Interobserver,Variations, Intra-Observer,Variations, Intraobserver,Variations, Observer
D016489 Head Injuries, Closed Traumatic injuries to the cranium where the integrity of the skull is not compromised and no bone fragments or other objects penetrate the skull and DURA MATER. This frequently results in mechanical injury being transmitted to intracranial structures which may produce TRAUMATIC BRAIN INJURIES, hemorrhage, or CRANIAL NERVE INJURIES. (From Rowland, Merritt's Textbook of Neurology, 9th ed, p417) Head Injuries, Nonpenetrating,Head Trauma, Closed,Closed Head Injuries,Head Injury, Blunt,Head Injury, Nonpenetrating,Injuries, Closed Head,Blunt Head Injuries,Blunt Head Injury,Closed Head Injury,Closed Head Trauma,Closed Head Traumas,Head Injuries, Blunt,Head Injury, Closed,Head Traumas, Closed,Nonpenetrating Head Injuries,Nonpenetrating Head Injury

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