Reliability of trachoma clinical grading--assessing grading of marginal cases.

ABSTRACT:

Background

Clinical examination of trachoma is used to justify intervention in trachoma-endemic regions. Currently, field graders are certified by determining their concordance with experienced graders using the kappa statistic. Unfortunately, trachoma grading can be highly variable and there are cases where even expert graders disagree (borderline/marginal cases). Prior work has shown that inclusion of borderline cases tends to reduce apparent agreement, as measured by kappa. Here, we confirm those results and assess performance of trainees on these borderline cases by calculating their reliability error, a measure derived from the decomposition of the Brier score.

Methods and findings

We trained 18 field graders using 200 conjunctival photographs from a community-randomize

SUBMITTER: Rahman SA 

PROVIDER: S-EPMC4006735 | biostudies-literature | 2014 May

REPOSITORIES: biostudies-literature