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Table 4 Diagnostic test accuracy of each grader by each pupil status (unit of analysis, by eyes, after excluding 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 71.1 (64.9, 77.4) 95.6 (94.1, 97.0) 80.8 (75.0, 86.6) 92.7 (90.8, 94.5) 0.70 (0.64, 0.76)
 Grader 2 66.4 (60.0, 72.7) 95.4 (94.0, 96.8) 78.9 (72.9, 84.9) 91.7 (89.8,93.5) 0.66 (0.60,0.72)
Mydiatric image
 Grader 1 76.2 (71.3, 81.0) 94.0 (92.6, 95.5) 79.1 (74.4, 83.9) 93.0 (91.4, 94.6) 0.71 (0.66, 0.76)
 Grader 2 75.2 (70.2, 80.1) 93.9 (92.5, 95.4) 78.3 (73.6, 83.1) 92.9 (91.3, 94.5) 0.70 (0.65, 0.75)
Referable DR gradinga
Non-mydiatric image
 Grader 1 73.6 (61.7, 85.5) 99.7 (99.3, 100.0) 92.9 (85.1, 100.7) 98.5 (97.7, 99.3) 0.81 (0.72, 0.90)
 Grader 2 71.7 (59.6, 83.8) 99.0 (98.4, 99.6) 79.2 (67.7, 90.7) 98.5 (97.8, 99.3) 0.74 (0.64, 0.84)
Mydiatric image
 Grader 1 81.8 (72.5, 91.1) 99.4 (99.0, 99.9) 88.5 (80.5, 96.5) 99.0 (98.5, 99.6) 0.84 (0.77, 0.91)
 Grader 2 89.4 (82.0, 96.8) 98.8 (98.2, 99.4) 79.7 (70.6, 88.9) 99.4 (99.0, 99.9) 0.83 (0.77, 0.90)
Maculopathy gradingb
Non-mydiatric image
 Grader 1 78.1 (68.6, 87.6) 96.6 (95.5,97.8) 65.5 (55.5, 75.5) 98.1 (97.29, 99.1) 0.69 (0.60, 0.77)
 Grader 2 64.1 (53.5, 74.8) 98.1 (97.3, 99.0) 73.5 (63.0, 84.0) 97.1 (96.1, 98.2) 0.66 (0.57, 0.75)
Mydiatric image
 Grader 1 81.0 (73.3, 88.7) 96.0 (94.9, 97.1) 63.3 (54.9, 71.6) 98.3 (97.6, 99.1) 0.68 (0.61, 0.75)
 Grader 2 75.3 (66.8,83.7) 97.8 (96.91, 98.6) 73.8 (65.3,82.3) 97.9 (97.1, 98.7) 0.72 (0.65, 0.79)
  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