title: Validation of an online referral guide for melanocytic fundus lesions.
abstract: OBJECTIVE
  To assess the validity of an online referral guide for melanocytic fund us lesions available to optometrists.
  
  
  METHODS
  A prospective inter-observer agreement assessment of a novel grading system for melanocytic fundus lesions using digital images from the Liverpool Ocular Oncology Centre.
  
  
  RESULTS
  The study was completed by 94.5% (52/55) of optometrists recruited. A total of 2594 valid grading scores were obtained for 400 different melanocytic lesions which were assigned to three management categories (monitor, routine referral or urgent referral). The linear weighted kappa value between the optometrists and the ocular oncologist was 0.66 (95% CI 0.64-0.68). Optometrist inter-observer agreement was 0.62 (95%CI 0.57-0.67).
  
  
  CONCLUSIONS
  This online referral guide for melanocytic lesions shows substantial agreement between optometrists and a gold standard opinion. It is easily accessible and could be helpful to community optometrists managing patients with a melanocytic fundus lesion.
authors: St Pauls Eye Unit, Royal Liverpool University Hospital, Liverpool, UK. chemmerdinger@gmail.com
authors: Christopher
authors: C
authors: Hemmerdinger
authors: Michael
authors: M
authors: Beech
authors: Carl
authors: C
authors: Groenewald
authors: Bertil
authors: B
authors: Damato
mesh_terms: D000328:Adult; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D008297:Male; D008875:Middle Aged; D009508:Nevus, Pigmented / Q000175:diagnosis*; D015588:Observer Variation; D009907:Optometry / Q000592:standards*; D010865:Pilot Projects; D011446:Prospective Studies; D012017:Referral and Consultation / Q000592:standards*; D015203:Reproducibility of Results; D019572:Retinal Neoplasms / Q000175:diagnosis*; D055815:Young Adult