Anton, AlfonsoNolivos, KarenPazos López, MartaFatti, GianlucaHerranz, AlejandraAyala, Eleonora M.Martínez-Prats, ElenaPeral, OscarVega-Lopez, ZaidaMonleon-Getino, AntoniMorilla-Grasa, AntonioComas Serrano, MercèCastells, Xavier2022-06-212022-06-212021Anton A, Nolivos K, Pazos M, Fatti G, Herranz A, Ayala-Fuentes ME, et al. Interobserver and intertest agreement in telemedicine glaucoma screening with optic disk photos and optical coherence tomography. J Clin Med. 2021 Jul 28; 10(15): 3337. DOI: 10.3390/jcm101533372077-0383http://hdl.handle.net/10230/53550Purpose: To evaluate interobserver and intertest agreement between optical coherence tomography (OCT) and retinography in the detection of glaucoma through a telemedicine program. Methods: A stratified sample of 4113 individuals was randomly selected, and those who accepted underwent examination including visual acuity, intraocular pressure (IOP), non-mydriatic retinography, and imaging using a portable OCT device. Participants' data and images were uploaded and assessed by 16 ophthalmologists on a deferred basis. Two independent evaluations were performed for all participants. Agreement between methods was assessed using the kappa coefficient and the prevalence-adjusted bias-adjusted kappa (PABAK). We analyzed potential factors possibly influencing the level of agreement. Results: The final sample comprised 1006 participants. Of all suspected glaucoma cases (n = 201), 20.4% were identified in retinographs only, 11.9% in OCT images only, 46.3% in both, and 21.4% were diagnosed based on other data. Overall interobserver agreement outcomes were moderate to good with a kappa coefficient of 0.37 and a PABAK index of 0.58. Higher values were obtained by experienced evaluators (kappa = 0.61; PABAK = 0.82). Kappa and PABAK values between OCT and photographs were 0.52 and 0.82 for the first evaluation. Conclusion: In a telemedicine screening setting, interobserver agreement on diagnosis was moderate but improved with greater evaluator expertise.application/pdfspaCopyright © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).info:eu-repo/semantics/articlehttp://dx.doi.org/10.3390/jcm10153337AgreementGlaucomaOptical coherence tomographyRetinographsScreeningTelemedicineinfo:eu-repo/semantics/openAccess