Razo Blanco-Hernández DM, Lima-Gómez V

Language: Spanish
References: 9
Page: 381-386
PDF size: 226.15 Kb.

ABSTRACT

Background: Ocular trauma produces psychological, social and occupational effects that can cause significant impairment. Evaluation of ocular trauma has been standardized by a system for classifying mechanical injuries of the eye (SCMIE). Parameters that are most commonly a source of error for the evaluator and that may lead to classification errors have not been identified.
Methods: An observational, retrospective, descriptive, cross-sectional and open study was conducted. Files of patients of either gender, aged 6 years or older, with ocular trauma graded with the SCMIE between 1997 and 2009 were re-evaluated by an independent investigator. The rate and 95% confidence intervals (95% CI) of evaluations that resulted in errors during the re-evaluation of ocular trauma were identified in the sample and in general for each parameter. The disparity between the initial evaluation and the re-evaluation (MacNemar) and the concordance between the evaluations (kappa) were analyzed.
Results: Of 817 evaluations, 294 had at least one grading error (36%, 95% CI 32.7-39.3). The most frequent error source was the parameter type. The disparity was significant in parameters type A, D, grade 2 and zone II. Overall concordance was good.
Conclusions: It is necessary to reinforce the learning curve for some parameters of the SCMIE, especially type, in order to improve its evaluation, so that it can become a valid communication tool that favors early referral to the specialist.

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