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Table 3 Diagnostic test accuracy of each grader by each pupil status (unit of analysis, by eyes, after including ungradable images)

From: Diagnostic test accuracy of diabetic retinopathy screening by physician graders using a hand-held non-mydriatic retinal camera at a tertiary level medical clinic

Index Test Sensitivity (95% CI) (%) Specificity (95% CI) (%) PPV (95% CI) (%) NPV (95% CI) (%) Kappa (95% CI) (%)
Any DR grading
Non-mydiatric image
 Grader 1 82.7 (78.5, 86.5) 70.4 (67.6, 73.1) 47.4 (43.4, 51.5) 92.7 (90.7, 94.4) 0.42 (0.38, 0.47)
 Grader 2 78.3 (73.7, 82.5) 76.2 (73.6, 78.8) 51.6 (47.3, 55.9) 91.6 (89.6, 93.3) 0.46 (0.42, 0.51)
Mydiatric image
 Grader 1 79.3 (74.7, 83.4) 89.2 (87.2, 90.9) 70.3 (65.6, 74.8) 93.0 (91.3, 94.5) 0.66 (0.61, 0.70)
 Grader 2 78.0 (73.4, 82.2) 91.5 (89.7, 93.1) 74.7 (70.0, 79.1) 92.8 (91.1, 94.3) 0.68 (0.64, 0.73)
Referable DR grading a
Non-mydiatric image
 Grader 1 86.8 (79.5, 92.3) 71.7 (69.2, 74.2) 20.4 (16.9, 24.3) 98.5 (97.6, 99.1) 0.23 (0.19, 0.28)
 Grader 2 84.9 (77.3, 90.9) 77.3 (75.0, 79.6) 23.8 (19.7, 28.3) 98.4 (97.5, 99.0) 0.29 (0.23, 0.34)
Mydiatric image
 Grader 1 88.7 (81.7, 93.8) 94.9 (93.6, 96.0) 59.1 (51.4, 66.6) 99.0 (98.4, 99.5) 0.68 (0.61, 0.75)
 Grader 2 92.5 (86.4, 96.5) 96.4 (95.3, 97.3) 68.0 (60.2, 75.3) 99.4 (98.8, 99.7) 0.76 (0.70, 0.82)
Maculopathy grading b
Non-mydiatric image
 Grader 1 89.2 (83.5, 93.5) 70.1 (67.5, 72.6) 26.5 (22.7, 30.4) 98.2 (97.2, 98.9) 0.29 (0.25, 0.34)
 Grader 2 80.4 (73.5, 86.6) 77.0 (74.6, 79.3) 29.7 (25.3, 34.3) 97.0 (95.8, 98.0) 0.33 (0.28,0.38)
Mydiatric image
 Grader 1 86.5 (80.4, 91.4) 91.5 (89.8, 92.9) 54.9 (48.5, 61.2) 98.3 (97.4, 98.9) 0.62 (0.56,0.68)
 Grader 2 82.4 (75.8, 87.9) 95.4 (94.1, 96.5) 68.2 (61.1, 74.7) 97.0 (96.9, 98.6) 0.71 (0.65,0.77)
  1. a-Referable level DR – moderate non-proliferative DR and above
  2. b-Maculopathy – presence of haemorrhage/s or exudates within 2-disc diameters of the centre of fovea