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    Discus: investigating subjective judgment of optic disc damage

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    Publication date
    2011-01-01
    Author
    Denniss, Jonathan
    Echendu, D.
    Henson, D.B.
    Artes, P.H.
    Keyword
    Discus
    Optic disc
    Damage
    Peer-Reviewed
    Yes
    
    Metadata
    Show full item record
    Abstract
    The purpose of the research was to describe a software package (Discus) for investigating clinicians' subjective assessment of optic disc damage [diagnostic accuracy in detecting visual field (VF) damage, decision criteria, and agreement with a panel of experts] and to provide reference data from a group of expert observers. Optic disc images were selected from patients with manifest or suspected glaucoma or ocular hypertension who attended the Manchester Royal Eye Hospital. Eighty images came from eyes without evidence of VF loss in at least four consecutive tests (VF negatives), and 20 images from eyes with repeatable VF loss (VF positives). Software was written to display these images in randomized order, for up to 60 s. Expert observers (n = 12) rated optic disc damage on a 5-point scale (definitely healthy, probably healthy, not sure, probably damaged, and definitely damaged). Optic disc damage as determined by the expert observers predicted VF loss with less than perfect accuracy (mean area under receiver-operating characteristic curve, 0.78; range, 0.72 to 0.85). When the responses were combined across the panel of experts, the area under receiver-operating characteristic curve reached 0.87, corresponding to a sensitivity of ∼60% at 90% specificity. Although the observers' performances were similar, there were large differences between the criteria they adopted (p < 0.001), even though all observers had been given identical instructions. Discus provides a simple and rapid means for assessing important aspects of optic disc interpretation. The data from the panel of expert observers provide a reference against which students, trainees, and clinicians may compare themselves. The program and the analyses described in this article are freely accessible from http://www.discusproject.blogspot.com/.
    URI
    http://hdl.handle.net/10454/16322
    Version
    No full-text in the repository
    Citation
    Denniss J, Echendu D, Henson DB et al (2011) Discus: investigating subjective judgment of optic disc damage. Optometry and Visual Science. 88(1): E93-101.
    Link to publisher’s version
    https://doi.org/10.1097/OPX.0b013e3181fc30d2
    Type
    Article
    Collections
    Life Sciences Publications

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