title: Lens Opacities Classification System III: cataract grading variability between junior and senior staff at a Singapore hospital.
abstract: OBJECTIVE
  To test the reliability of the Lens Opacities Classification System III (LOCS III) cataract grading between observers at different levels of ophthalmology experience.
  
  
  METHODS
  Ophthalmology Department, National University Hospital, Singapore, Singapore.
  
  
  METHODS
  In this comparative study, a non-ophthalmology trainee, a basic ophthalmology trainee, and an ophthalmology consultant graded cataracts in 28 patients preoperatively. The observers had a meeting to discuss their interpretations of the LOCS III manual to standardize the grading system and then graded 37 additional patients.
  
  
  RESULTS
  There was a statistically significant increase in inter-observer agreement in all 3 LOCS III categories after standardization of the LOCS III system. The kappa values after standardization fell in the moderate (0.41 to 0.60) to substantial (0.61 to 0.80) range. There was no statistically significant relationship between the observer's experience and the kappa values.
  
  
  CONCLUSIONS
  There was an increase in inter-observer agreement in all categories after standardization between operators.
authors.affiliation: Ophthalmology Department, National University Hospital, Singapore, Singapore. anna.tan.c.s@singhealth.com.sg
authors.forename: Anna C
authors.initials: AC
authors.lastname: Tan
authors.forename: Seng Chee
authors.initials: SC
authors.lastname: Loon
authors.forename: Harold
authors.initials: H
authors.lastname: Choi
authors.forename: Lennard
authors.initials: L
authors.lastname: Thean
mesh_terms: D002386:Cataract / Q000145:classification*; D002983:Clinical Competence; D006785:Hospitals, University; D006801:Humans; D007907:Lens Nucleus, Crystalline / Q000473:pathology*; D008505:Medical Staff, Hospital; D015588:Observer Variation; D009885:Ophthalmology / Q000193:education*; D015203:Reproducibility of Results; D012846:Singapore