DefinePK

Research Objective

To determine the agreement between subjective and objective parameters using meibography for the assessment of dry eye syndrome, and to compare the reliability of a 5-grade scale with a 4-grade scale and computerized grading.

Methodology

A cross-sectional observational study was conducted with 100 patients diagnosed with Meibomian Gland Dysfunction. Non-contact infra-red meibography was performed. Subjective assessment was done using four-grade and five-grade scales, while objective assessment used computerized grading. Data was collected by a single investigator, and images were graded by three masked observers in two sessions.

Methodology Flowchart

                        graph TD
    A["Patient Recruitment n=100"] --> B["Meibography Imaging"];
    B --> C["Subjective Assessment"4-grade, 5-grade""];
    B --> D["Objective Assessment"Computerized Grading""];
    C --> E["Data Analysis"];
    D --> E;
    E --> F["Comparison of Scales"];
    F --> G["Conclusion"];                    

Discussion

The study compared different grading scales for meibography in dry eye disease. While previous studies suggested the 5-grade scale offered better repeatability, this study found the 4-grade scale to be more reliable. Computerized grading was consistently found to provide better intra and inter-observer agreement, aligning with other research. The authors noted the importance of observer training and suggested that Artificial Intelligence might eliminate observer bias in the future.

Key Findings

Statistically significant differences were observed between sessions for the 4-grade and 5-grade scales (p<0.001). No statistically significant difference was seen in computerized grading (p>0.05). Correlations between observers were best with the 5-grade scale, followed by the computerized 100-grade scale and the 4-grade scale. The reliability of the 5-grade scale was found to be poorer than the 4-grade scale in this study. Computerized grading offered better intra and inter-observer assessment.

Conclusion

The reliability of the 5-grade scale was found to be poorer compared to the 4-grade scales in this study, contrary to some previous findings. Computerized grading demonstrated better intra and inter-observer assessment, supporting its utility in evaluating Meibomian Gland Dysfunction.

Fact Check

1. Study Duration: The study was conducted from August 2021 to February 2022. (Confirmed in text)
2. Participant Gender Distribution: 60% of the 100 participants were male, and 40% were female. (Confirmed in text)
3. Statistical Significance: A statistically significant difference was seen in Session I OII vs Session II OII (p-value <0.001) for Grade-4. (Confirmed in text)

Mind Map