Interobserver Agreement Among Uveitis Experts on Uveitic Diagnoses: The Standardization of Uveitis Nomenclature Experience

Research output: Contribution to journalArticlepeer-review


  • Douglas A. Jabs
  • Andrew Dick
  • John T. Doucette
  • Amod Gupta
  • Susan Lightman
  • Peter McCluskey
  • Annabelle A. Okada
  • Alan G. Palestine
  • James T. Rosenbaum
  • Sophia M. Saleem
  • Jennifer Thorne
  • Brett Trusko
  • Phil Murray
  • Standardization of Uveitis Nomenclature Working Group (SUN)

Colleges, School and Institutes

External organisations

  • Icahn School of Medicine at Mount Sinai
  • Institute of Ophthalmology, University College London
  • Postgraduate Institute of Medical Education and Research
  • University of Sydney
  • Kyorin University School of Medicine
  • University of Colorado School of Medicine
  • Oregon Health and Sciences University
  • Johns Hopkins Bloomberg School of Public Health
  • Texas A&M Health Science Centre College of Medicine


Purpose: To evaluate the interobserver agreement among uveitis experts on the diagnosis of the specific uveitic disease. Design: Interobserver agreement analysis. Methods: Five committees, each comprised of 9 individuals and working in parallel, reviewed cases from a preliminary database of 25 uveitic diseases, collected by disease, and voted independently online whether the case was the disease in question or not. The agreement statistic, κ, was calculated for the 36 pairwise comparisons for each disease, and a mean κ was calculated for each disease. After the independent online voting, committee consensus conference calls, using nominal group techniques, reviewed all cases not achieving supermajority agreement (>75%) on the diagnosis in the online voting to attempt to arrive at a supermajority agreement. Results: A total of 5766 cases for the 25 diseases were evaluated. The overall mean κ for the entire project was 0.39, with disease-specific variation ranging from 0.23 to 0.79. After the formalized consensus conference calls to address cases that did not achieve supermajority agreement in the online voting, supermajority agreement overall was reached on approximately 99% of cases, with disease-specific variation ranging from 96% to 100%. Conclusions: Agreement among uveitis experts on diagnosis is moderate at best but can be improved by discussion among them. These data suggest the need for validated and widely used classification criteria in the field of uveitis.


Original languageEnglish
Pages (from-to)19-24
JournalAmerican Journal of Ophthalmology
Early online date6 Nov 2017
Publication statusPublished - 1 Feb 2018