title: Inter-Rater Agreement in the Assessment of Video Recordings of Eye Drop Instillation by Glaucoma Patients.
abstract: OBJECTIVE
  To create a standardized method for evaluating the video recordings of patients self-instilling eye drops and to determine the level of agreement of eye drop instillation efficacy, safety and efficiency ratings by three masked graders.
  
  
  METHODS
  Prospective cross-sectional study.
  
  
  METHODS
  78 patients with open-angle glaucoma or ocular hypertension who had at least 6 months of experience with the use of eye drop medications.
  
  
  METHODS
  Participants were video recorded while self-instilling artificial tears sequentially to both eyes. Three masked observers graded these video recordings on three criteria: efficacy (the determination of whether an eye drop was instilled on the ocular surface), safety (assessment of whether the tip of the medication bottle made contact with the ocular surface or eyelids), and efficiency (the number of eye drops expressed from the bottle).
  
  
  METHODS
  After grading the video recordings based on efficacy, safety, and efficiency, kappa statistics were used to estimate inter-rater agreement.
  
  
  RESULTS
  The mean kappa level of agreement for efficacy, safety, and efficiency was 0.64 (95% confidence interval (CI), 0.42-0.87), 0.73 (95% CI, 0.58-0.88), and 0.62 (95% CI, 0.42-0.81), respectively.
  
  
  CONCLUSIONS
  We demonstrated good inter-rater reproducibility of the masked analysis of video recordings of patients self-instilling eye drops based on three criteria: efficiency, safety, and efficacy.
authors.affiliation: Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America.
authors.forename: Meghan S
authors.initials: MS
authors.lastname: Park
authors.affiliation: Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America.
authors.forename: Marguerite M
authors.initials: MM
authors.lastname: Patel
authors.affiliation: Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA, United States of America.
authors.forename: Daniel
authors.initials: D
authors.lastname: Sarezky
authors.affiliation: Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America.
authors.forename: Carin
authors.initials: C
authors.lastname: Rojas
authors.affiliation: Department of Ophthalmology, University of Arizona, Tucson, AZ, United States of America.
authors.forename: Clara
authors.initials: C
authors.lastname: Choo
authors.affiliation: Department of Ophthalmology, Mayo Clinic, Rochester, MN, United States of America.
authors.forename: Michael
authors.initials: M
authors.lastname: Choi
authors.affiliation: Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America.
authors.forename: Dachao
authors.initials: D
authors.lastname: Liu
authors.affiliation: Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America.
authors.forename: Alfred W
authors.initials: AW
authors.lastname: Rademaker
authors.affiliation: Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America.
authors.forename: Angelo P
authors.initials: AP
authors.lastname: Tanna
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005902:Glaucoma, Open-Angle / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D008875:Middle Aged; D009798:Ocular Hypertension / Q000517:prevention & control*; D009883:Ophthalmic Solutions / Q000008:administration & dosage / Q000627:therapeutic use*; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D011446:Prospective Studies; D015203:Reproducibility of Results; D012646:Self Administration; D014741:Video Recording / Q000379:methods*; D016903:Drug Monitoring
chemical_list: D009883:Ophthalmic Solutions