Locality is the strongest predictor of expert performance in image-based differentiation of bacterial and fungal corneal ulcers from India
Copyright © 2024 Copyright: © 2024 Indian Journal of Ophthalmology..
PURPOSE: This study sought to identify the sources of differential performance and misclassification error among local (Indian) and external (non-Indian) corneal specialists in identifying bacterial and fungal keratitis based on corneal photography.
METHODS: This study is a secondary analysis of survey data assessing the ability of corneal specialists to identify acute bacterial versus fungal keratitis by using corneal photography. One-hundred images of 100 eyes from 100 patients with acute bacterial or fungal keratitis in South India were previously presented to an international cohort of cornea specialists for interpretation over the span of April to July 2021. Each expert provided a predicted probability that the ulcer was either bacterial or fungal. Using these data, we performed multivariable linear regression to identify factors predictive of expert performance, accounting for primary practice location and surrogate measures to infer local fungal ulcer prevalence, including locality, latitude, and dew point. In addition, Brier score decomposition was used to determine experts' reliability ("calibration") and resolution ("boldness") and were compared between local (Indian) and external (non-Indian) experts.
RESULTS: Sixty-six experts from 16 countries participated. Indian practice location was the only independently significant predictor of performance in multivariable linear regression. Resolution among Indian experts was significantly better (0.08) than among non-Indian experts (0.01; P < 0.001), indicating greater confidence in their predictions. There was no significant difference in reliability between the two groups ( P = 0.40).
CONCLUSION: Local cornea experts outperformed their international counterparts independent of regional variability in tropical risk factors for fungal keratitis. This may be explained by regional characteristics of infectious ulcers with which local corneal specialists are familiar.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:72 |
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| Enthalten in: |
Indian journal of ophthalmology - 72(2024), 4 vom: 01. März, Seite 526-532 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Rosenberg, Christopher R [VerfasserIn] |
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| Anmerkungen: |
Date Completed 29.03.2024 Date Revised 29.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.4103/IJO.IJO_3396_22 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM369445821 |
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| 100 | 1 | |a Rosenberg, Christopher R |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Locality is the strongest predictor of expert performance in image-based differentiation of bacterial and fungal corneal ulcers from India |
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| 500 | |a Date Revised 29.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2024 Copyright: © 2024 Indian Journal of Ophthalmology. | ||
| 520 | |a PURPOSE: This study sought to identify the sources of differential performance and misclassification error among local (Indian) and external (non-Indian) corneal specialists in identifying bacterial and fungal keratitis based on corneal photography | ||
| 520 | |a METHODS: This study is a secondary analysis of survey data assessing the ability of corneal specialists to identify acute bacterial versus fungal keratitis by using corneal photography. One-hundred images of 100 eyes from 100 patients with acute bacterial or fungal keratitis in South India were previously presented to an international cohort of cornea specialists for interpretation over the span of April to July 2021. Each expert provided a predicted probability that the ulcer was either bacterial or fungal. Using these data, we performed multivariable linear regression to identify factors predictive of expert performance, accounting for primary practice location and surrogate measures to infer local fungal ulcer prevalence, including locality, latitude, and dew point. In addition, Brier score decomposition was used to determine experts' reliability ("calibration") and resolution ("boldness") and were compared between local (Indian) and external (non-Indian) experts | ||
| 520 | |a RESULTS: Sixty-six experts from 16 countries participated. Indian practice location was the only independently significant predictor of performance in multivariable linear regression. Resolution among Indian experts was significantly better (0.08) than among non-Indian experts (0.01; P < 0.001), indicating greater confidence in their predictions. There was no significant difference in reliability between the two groups ( P = 0.40) | ||
| 520 | |a CONCLUSION: Local cornea experts outperformed their international counterparts independent of regional variability in tropical risk factors for fungal keratitis. This may be explained by regional characteristics of infectious ulcers with which local corneal specialists are familiar | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Prajna, Venkatesh |e verfasserin |4 aut | |
| 700 | 1 | |a Srinivasan, Muthiah K |e verfasserin |4 aut | |
| 700 | 1 | |a Lalitha, Prajna C |e verfasserin |4 aut | |
| 700 | 1 | |a Krishnan, Tiru |e verfasserin |4 aut | |
| 700 | 1 | |a Rajaraman, Revathi |e verfasserin |4 aut | |
| 700 | 1 | |a Venugopal, Anitha |e verfasserin |4 aut | |
| 700 | 1 | |a Acharya, Nisha |e verfasserin |4 aut | |
| 700 | 1 | |a Seitzman, Gerami D |e verfasserin |4 aut | |
| 700 | 1 | |a Rose-Nussbaumer, Jennifer |e verfasserin |4 aut | |
| 700 | 1 | |a Woodward, Maria A |e verfasserin |4 aut | |
| 700 | 1 | |a Lietman, Thomas M |e verfasserin |4 aut | |
| 700 | 1 | |a Campbell, John Peter |e verfasserin |4 aut | |
| 700 | 1 | |a Keenan, Jeremy D |e verfasserin |4 aut | |
| 700 | 1 | |a Redd, Travis K |e verfasserin |4 aut | |
| 700 | 0 | |a Corneal Ulcer Image Interpretation Study Group |e verfasserin |4 aut | |
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