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How reliable is the lacrimal scintigraphy report? An interobserver agreement and reliability study

International Journal of Ophthalmology(English edition) 2019年第3期12卷 401-406页

作者： Mohsen Bahmani Kashkouli navid abolfathzadeh Parya Abdolalizadeh Nasser Karimi Raheleh Hedayati Samira Jafari Amirpooya Alemzadeh Eye Research Center Rassoul Akram Hospital Iran University of Medical Sciences Department of Nuclear Medicine Rassoul Akram Hospital Iran University of Medical Sciences

AIM: To assess the inter-observer agreement and reliability as well as intra-observer repeatability for lacrimal scintigraphy(LS) reports with and without considering the irrigation test ***: A prospective, observational, cross sectional study. Two masked clinicians(lacrimal surgeon and nuclear medicine specialist) independently reported 100 LS images(50 patients of >6 years of age with unilateral anophthalmic socket) in a university hospital. The lacrimal surgeon performed a diagnostic irrigation test and repeated the report of the same LS images 2 y after the first report(intra-observer agreement). A weighted Kappa analysis was performed to determine inter-observer agreement and reliability as well as intra-observer repeatability for the type(normal, partial and complete obstruction) and location(presac, preduct, and intraduct) of the obstruction. Subgroup analysis was also performed with consideration of irrigation test results. RESULTS: A significantly moderate agreement was found between lacrimal surgeon and nuclear medicine specialist for both the type(Kappa=0.55) and location(Kappa=0.48) of obstruction. Agreement values were higher for the type(Kappa=0.61 vs 0.41) and location(Kappa=0.56 vs 0.31) of obstruction in cases with normal than abnormal irrigation test. Strong and significant intraobserver(lacrimal surgeon) repeatability was found for both the type(Kappa=0.66) and location(Kappa=0.69) of obstruction. LS showed no to slight reliability based on irrigation ***: A moderate agreement is found between lacrimal surgeon and nuclear medicine specialist regarding the interpretation of LS suggesting the importance ofconsensus groups among nuclear medicine specialists and lacrimal surgeons to create a common language for interpretation of LS. Intra-observer repeatability is strong for the lacrimal surgeon.

关键词： epiphora lacrimal drainage lacrimal scintigraphy reliability agreement

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