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The combined influence of knowledge, training and experience when grading contact lens complications
Author(s) -
Efron Nathan,
Morgan Philip B.,
Jagpal Ritu
Publication year - 2003
Publication title -
ophthalmic and physiological optics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.147
H-Index - 66
eISSN - 1475-1313
pISSN - 0275-5408
DOI - 10.1046/j.1475-1313.2003.00091.x
Subject(s) - contact lens , grading (engineering) , medicine , optometry , grading scale , ophthalmology , surgery , civil engineering , engineering
Purpose: A study was conducted to evaluate the influence of knowledge, training and experience (clinical skills set) when assessing the severity of contact lens complications. Methods: Nine optometrists (who were in possession of a relevant clinical skills set) and nine ‘non‐optometrists’ (subjects without the clinical skills set) were each invited to grade – to the nearest 0.1 increment – an image of each of 16 contact lens complications using Efron Grading Scales for Contact Lens Complications. This procedure was repeated 2 weeks later, yielding a total data base comprising 576 individual grading estimates. Results: The mean of the test and retest grading estimates was the same for the optometrists (2.8 ± 0.7) and the non‐optometrists (2.6 ± 0.9) ( F 1,15,1  = 1.3, p  = 0.26); that is, non‐optometrists can grade accurately. Median grading reliability for optometrists (±0.41) was lower than (i.e. superior to) that for non‐optometrists (±0.67) ( p  = 0.001). Non‐optometrists tended to display a reluctance to grade by interpolation and to less reliably grade subtle clinical signs. Conclusions: When averaged over several attempts, non‐optometrists will arrive at similar estimates of severity to optometrists when grading ocular complications of contact lens wear; however, they will do so less reliably. The relative contribution of the three attributes of the clinical skills set to grading performance is presently unclear.

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