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To assess whether a VISA grading atlas improves ophthalmology trainees\u2019 performance in photographic assessment of TED.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective, partially randomized, international study conducted from September 2021 to May 2022. Online study invitation was emailed to a volunteer sample group of 68 ophthalmology college accredited consultants and trainees, and 6 were excluded from the study. Participants were asked to score 10 patient photographs of TED using only the inflammation and motility restriction components of the VISA classification. IRR was compared between groups of practitioners by their level of experience. A clinical activity grading atlas was randomized to 50% of the ophthalmology trainees.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall rater ICC was 0.96 for inflammation and 0.99 for motility restriction. No statistically significant difference in IRR between rater groups was identified. Trainees with a grading atlas had the highest IRR for inflammation (ICC\u2009=\u20090.95). Each subcomponent of the inflammation and motility restriction components of VISA classification had an ICC considered good to excellent. The mean overall rater score was 4.6\/9 for inflammation and 3.5\/12 for motility restriction. For motility restriction there was a reduced mean score variance among all raters when scoring photographs with more severe motility restriction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>IRR using the inflammation and motility restriction components of the VISA classification was excellent. A VISA grading atlas improved trainee performance in grading inflammation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10792-024-02934-z","type":"journal-article","created":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T00:02:08Z","timestamp":1708387328000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Interrater reliability of photographic assessment of thyroid eye disease using the VISA classification"],"prefix":"10.1007","volume":"44","author":[{"given":"Antony C.","family":"Boynes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas J.","family":"Enright","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas G.","family":"Hardy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jwu Jin","family":"Khong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,20]]},"reference":[{"key":"2934_CR1","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/j.ajo.2019.07.021","volume":"208","author":"A Patel","year":"2019","unstructured":"Patel A, Yang H, Douglas RS (2019) A new era in the treatment of thyroid eye disease. 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Approval was granted by the Ethics Committee of The Royal Victorian Eye and Ear Hospital on 25\/10\/21, Ethics ID: 21\/1515HL.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to Participate"}},{"value":"The authors affirm that human research participants provided informed consent for publication of the images in Supp Fig.\u00a0\n                      \n                      a and Supp Fig.\u00a0\n                      \n                      b.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to Publish"}}],"article-number":"98"}}